Dhia mus rau cov ntsiab lus
Tsev CalAIM: Hloov Medi-Cal Cov Kev Txhais Lus ntawm ASCMI Forms

ASCMI Cov Ntawv Txhais Lus

Rov qab mus rau nplooj ntawv CalAIM ASCMI Initiative

DHCS-0303 ASCMI Form AB 133
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese

DHCS-0309 ASCMI Form Non-AB 133
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese

DHCS-0310 ASCMI Revocation Form
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese