What documents do I need to bring to my Healthy San Francisco application appointment?

When you go to your Healthy San Francisco application appointment, you will need to provide the following documents:

  • Personal identification
  • Proof of residency
  • Proof of household income and assets

To prove your personal identification, you can use any ONE of the following:

  • State Issued Driver License or ID
  • San Francisco ID card
  • U.S Passport
  • Student Picture ID
  • Certificate of Naturalization N-550/N-570
  • U.S Mariner Card
  • Permanent or Temporary Residency Card
  • Consular ID
  • School Record with a date & place of birth and parents listed
  • Certificate of Indian Blood or US American Indian tribal document
  • Employment Authorization Card or ID

To provide proof of your San Francisco residency, you can provide any ONE of the following documents:

  • State Issued Driver License or ID
  • Current paycheck
  • Bank Statement with your San Francisco address
  • Utility Bill with a San Francisco address
  • San Francisco Unified School District School Registration
  • Social Security Insurance Awards Letter
  • DMV registration
  • Pension check or statement
  • Social Security Award Letter
  • General Assistance Letter
  • Affidavit of Support — An affidavit of support is a form filled out by someone you live with to vouch for your residency. They will need to provide one of the above items in their name along with the affidavit form. You can download the form from here.

You can provide proof of your income and assets by showing ALL of the following documents that exist and are applicable for any member of the applicant household:

  • Current paycheck stub
  • Current tax return
  • Signed Statement From your Employer (download form)
  • Bank Statement
  • Rental Income Receipts or 1040 tax return
  • Bank Book or Annuity Statement
  • Unemployment Benefits Statement
  • Veteran's Statement
  • Worker Compensation Statement
  • Copy of Award Letter
  • Non-retirement stocks, bonds or certificates of deposit.
  • Account statements for any retirement accounts, such as 401K, or 403b accounts

 

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