Forms
AGENCY INFORMATION - Health Plans or Community-Based Organizations who want to work at LAUSD School sites conducting health insurance outreach and enrollment must complete the following documents and submit to the CHAMP Coordinator. Community agencies may contact the CHAMP Coordinator at 213-241-4293. In order to become an outreach and enrollment partner, CBOs and/or health plans must enter into a memorandum of understanding, provide proof of liability insurance, adhere to professional standards of conduct, work within assigned schools and comply with additional program requirements.