Daim Ntawv Qhia Tshuaj Kho Mob Medi-Cal
- MC 5120AD – Vendor Approver Certification(PDF)
- MC 5121AD – Daim Ntawv Pov Thawj Pom Zoo Los Ntawm Tus Muab Kev Pab Cuam Los Ntawm Lub Nroog(PDF)
- MC 5123AD – Daim Ntawv Pov Thawj Pom Zoo Rau Cov Neeg Ua Haujlwm DHCS (PDF)
- MC 5131AD – County-Direct Provider User Cancellation(PDF)
- Daim Ntawv Thov Kev Pab DHCS 5311 Daim Ntawv Pov Thawj: Kev Thov Nyiaj Rov Qab Rau Kev Tshuaj Medi-Cal (DMC) - Kev Pov Thawj Siv Tshuaj (QA/UR) Cov Nqi (PDF)
- Thov hu rau BHFSOps@dhcs.ca.gov lub inbox kom tau txais phau ntawv ua haujlwm thov uas nrog daim ntawv pov thawj thov no.
- Thov hu rau BHFSOps@dhcs.ca.gov lub inbox kom tau txais phau ntawv ua haujlwm thov uas nrog daim ntawv pov thawj thov no.
- DHCS 5312 Daim Ntawv Qhia Txog Kev Thov: Tshuaj Medi-Cal (DMC) Cov Kev Pabcuam Thov rau Kev Them Nyiaj Rov Los Ntawm Lub Nroog Tus Nqi Se (PDF)
- Thov hu rau SUDFMAB@dhcs.ca.gov lub inbox kom tau txais phau ntawv ua haujlwm thov uas nrog daim ntawv pov thawj thov no.
- Daim Ntawv DHCS 6065A - Daim Ntawv Pov Thawj Zoo (PDF)
- DHCS 6065A Cov Lus Qhia – Daim Ntawv Pov Thawj Ua Zoo (PDF)
- Daim Ntawv DHCS 6065B - Daim Ntawv Pov Thawj Zoo (PDF)
- Cov Lus Qhia ntawm DHCS 6065B - Daim Ntawv Pov Thawj Zoo (PDF)
- Daim Ntawv DHCS 6700 - Daim Ntawv Pov Thawj Hloov Kev Them Nqi Ntau Zaug (PDF)
- Cov Lus Qhia ntawm DHCS 6700 - Cov Lus Qhia Txog Kev Pom Zoo Txog Kev Them Nqi Ntau Zaug (PDF)
- Daim Ntawv DHCS 100185 - Daim Ntawv Pov Thawj Xa Daim Ntawv Thov DMC - Tus Muab Daim Ntawv Cog Lus Ncaj Qha (PDF)
- Cov Lus Qhia ntawm DHCS 100185 - Daim Ntawv Pov Thawj Xa Daim Ntawv Thov ntawm DMC - Tus Muab Daim Ntawv Cog Lus Ncaj Qha (PDF)
- Daim Ntawv Foos DHCS 100186 - Daim Ntawv Pov Thawj Xa Daim Ntawv Thov DMC - Tus Muab Kev Pabcuam Cog Lus Hauv Lub Nroog (PDF)
- Cov Lus Qhia ntawm DHCS 100186 - Daim Ntawv Pov Thawj Xa Daim Ntawv Thov ntawm DMC - Tus Muab Kev Pabcuam Cog Lus ntawm Lub Nroog (PDF)
- Daim Ntawv DHCS 100187 - Daim Ntawv Pov Thawj Xa Daim Ntawv Thov Kev Pab ntawm DMC - Daim Ntawv Muab Kev Pabcuam uas Lub Nroog Ua Haujlwm (PDF)
- DHCS 100224 – Daim Ntawv Pov Thawj Medi-Cal Tshuaj Rau Kev Them Rov Qab Los Ntawm Tsoom Fwv Teb Chaws (PDF) – Kho Dua Tshiab 04/2025
- Daim Ntawv DHCS 8049 - Daim Ntawv Pov Thawj Ua Raws Cai ntawm Lub Nroog (PDF) - Kho dua tshiab 04/2024
- Cov Lus Qhia ntawm DHCS 8049 - Daim Ntawv Pov Thawj Ua Raws Cai ntawm Lub Nroog (PDF)
- DHCS 5260 Form – SUDCRS Approver Form (PDF)