Molina Community Supports
Personal Care and Homemaker Patient Package
The full personal care and homemaker package to bring to your doctor's office. It contains the page for your provider, the fax cover sheet, and the Molina referral form.
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How to use this package
- 1Open the package and read the provider page with your doctor or clinic staff.
- 2Fill in your member information on the referral form.
- 3Have the office sign and date the provider page.
- 4Ask the office to fax the completed package and supporting records to Molina at (833) 305-3130.
- 5Tell Coast Care the fax date so we can track the referral.
Questions about the paperwork?
Call the office at (619) 354-2544 and we will walk you through it. The full steps are also on the FAQ page.