DHCS 0001 (1/08) - U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity (Arabic)
DHCS 0002 (1/08) - Proof of Citizenship and Identity--New Requirements for Medi-Cal Beneficiaries who are U.S. Citizens or Nationals (Arabic)
DHCS 0003 (6/07) - Affidavit of Reasonable Effort to Get Proof of Citizenship (Arabic)
DHCS 0004 (6/07) - Request for California Birth Record (Arabic)
DHCS 0005 (2/08) - Reciept of Citizenship or Identity Documents (Arabic)
DHCS 0006 (8/07) - Proof of Citizenship and Identity (Arabic)
DHCS 0007 (12/07) - Acceptable Citizenship and Identity Documents - (Arabic)
DHCS 0008 (1/08) - Proof of Citizenship and Identity Requirements--For Children who are U.S. Citizens or Nationals filling out the Healthy Families/Medi-Cal Joint Application (Arabic)
DHCS 0009 (9/07) - Affidavit of Identity for U.S. Citizen or National Children Under 18 (Arabic)
DHCS 0011 (6/08) - Proof of Acceptable Citizenship or Identity Documents (Arabic)
MC 0021 (4/07) - Medi-Cal to Healthy Families Bridging Consent Form (Arabic)
MC 239 DRA-1 (12/07) - Approval for Limited Benefits with No Share of Cost (Arabic)
MC 239 DRA-2 (12/07) - Approval for Limited Benefits with Share of Cost (Arabic)
MC 239 DRA-3 (12/07) - Change to Limited Benefits with No Share of Cost (Arabic)
MC 239 DRA-4 (12/07) - Change to Limited Benefits with Share of Cost (Arabic)
MC 239 DRA-5 (12/07) - Approval for Full-Scope Benefits (Arabic)
MC 239 P-2 (04/08) - Restricted Benefits Approval with No Share of Cost: Referred to the County or Local-Sponsored Health Insurance Program (Arabic)
MC 239 P-3 (04/08) - Restricted Benefits Approval with Share of Cost: Referred to the County or Local-Sponsored Health Insurance Program (Arabic)
MC 239 P-4 (04/08) - Restricted Benefits Approval with No Share of Cost: Not Referred to the County or Local-Sponsored Health Insurance Program (Arabic)
MC 239 P-5 (04/08) - Restricted Benefits Approval with Share of Cost: Not Referred to the County or Local-Sponsored Health Insurance Program (Arabic)
MC 321 HFP (12/07) (Not DHCS) - Healthy Families/Medi-Cal Joint Application (Arabic)
MC 4034 (1/08) - Language Services Notice (Multilingual)
MC 4035 (4/08) - Medi-Cal Consent Form (Arabic)