INFORMATION SHEET AND INSTRUCTIONS FOR REQUEST …
copy of Application and Order for Health Insurance Coverage (form FL-470) or National Medical Support Notice (form OMB-0970-0222). The address of the court clerk is the same as the one shown for the superior court on the health insurance coverage assignment order.
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CALIFORNIA Child Support Services
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www.courts.ca.govNOTICE: If you object to the Application and Order for Health Insurance Coverage (form FL-470) or National Medical Support Notice (form OMB-0970-0222), complete and file this form with the court clerk to request a hearing.
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