Forms By Name – H
- Health Assessment Provider Agreement (DHCS 4491)
- Health Assessment Provider Application (DHCS 4490)
- Health Care Practitioner Incidental Medical Services Acknowledgement (DHCS 5256)
- Health Insurance Information (MC 2600, 09/07)
Alt: Spanish - Health Screening Report (DHCS 5077)
- Healthy Families/Medi-Cal Joint Application Order Form (English) (MC307, 06/13)
- Hmong – Notice of Supplemental Form for Express Enrollment Applicants (Hmong) (MC 368, 06/07)