Community Assistance Office at Vida Appointment Form FILL OUT THE FORM BELOW OR CALL IF YOU NEED ASSISTANCE. "*" indicates required fields CommentsThis field is for validation purposes and should be left unchanged.Name* First Last County*AtascosaBanderaBexarComalGuadalupeKendallMedinaWilsonPhoneEmail Member IDAppointment Type*Select OnePhoneEmailIn-Person (Vida Location)In-Home VisitI need help with…* Applying for health coverage Renewing my/my child’s health coverage Learning about community resources Other If "other" was selected, please enter your question below* Δ
