Skip to content
Enrollment Application for
Medi-Cal Peer Support Specialist Training
*
1.
Are you a California (CA) resident?
(Required.)
Yes
No
If no, list your state of residency
*
2.
Name the CA County you live in:
(Required.)
*
3.
Age:
(Required.)
16 or Under
17
18-25
26-64
65+
*
4.
Do you have at least a GED, High School Diploma, or advanced degree?
(Required.)
Yes
No
*
5.
Do you identify as an individual with "lived experience" (someone who has received services for a mental/substance use disorder/behavioral health issue or are a family member or caregiver who has assisted someone with these services) and are dedicated to helping people recover from similar experiences?
(Required.)
Yes
No
250%
