California & Minnesota residents!
Please fill in every answer to the best of your ability. For those utilizing private insurance (or Minnesota students), please be sure to email pictures of your insurance card (front and back) to firstname.lastname@example.org. Those utilizing UCSHIP (California students), please contact your on-campus student health services to receive your referral (if applicable).
Questions? Email email@example.com or call/text 323.284.6801!