• MC 306 (06/07) – Kev Xaiv Tus Neeg Sawv Cev​​ 
  Alt: Spanish (01/08)
  ​​ 
• MC 322 (05/07) – Khoom Vaj Tse thiab Khoom Vaj Tse Tus Kheej – Ntxiv rau Daim Ntawv Thov Medi-Cal Xa Ntawv​​ 
  Alt: Spanish (09/07)
  ​​ 
• MC 324 (05/07) – Sneede tawm tsam Kizer Tshooj 1931(b) Daim Ntawv Ua Haujlwm Txog Vaj Tse​​ 
  
• MC 325 (05/07) – Daim Ntawv Thov Medi-Cal Hloov Chaw (TMC) lossis Medi-Cal Plaub Hlis Txuas Ntxiv Mus​​ 
  
• MC 326 A (05/07) – Txoj Kev Pab Nyiaj Txiag Ntxiv (SSI) Daim Ntawv Ua Haujlwm Txog Kev Tsim Nyog Tau Nyiaj Hli Rau Cov Neeg Laus​​ 
  
• MC 326 C (05/07) – Daim Ntawv Ua Haujlwm Txog Kev Them Nyiaj Ntxiv (SSI) – Tus Menyuam Tsim Nyog uas Muaj Niam Txiv Tsis Tsim Nyog lossis Niam Txiv Uas Tsis Tsim Nyog​​ 
  
• MC 327 A (05/07) – Daim Ntawv Ua Haujlwm Txog Vaj Tse thiab Vaj Tse rau Cov Neeg Laus (Supplemental Security Income - SSI) Program​​ 
  
• MC 327 C (05/07) – Supplemental Security Income (SSI) Program Property Worksheet Child​​ 
  
• MC 330 (10/24) – Kev Xa Mus Rau Cov Menyuam Mos Tshiab (Tsis Yog Daim Ntawv Thov Medi-Cal (sau tau)​​ 
  Lwm hom lus: Arabic, Armenian, Cambodian, Suav, Farsi, Hindi, Hmoob, Nyiv Pooj, Kauslim, Laotian, Mien, Punjabi, Lavxias, Mev, Tagalog, Thaib, Ukrainian, Nyab Laj Lloj Font: Lus Askiv​​ 
• MC 337 (05/07) - Daim Ntawv Ua Haujlwm Txheeb Xyuas Niam Txiv Tsis Muaj Haujlwm Ua 100 Teev lossis Ntau Dua​​ 
  
• MC 338 (05/07) – 250 Percent Income Test Work Sheet for the 250 Percent Working Disabled Program – Adults​​ 
  Alt: Cov lus qhia
  ​​ 
• MC 338 A (05/07) – Daim Ntawv Ua Haujlwm Xeem Nyiaj Tau Los ntawm SSI/SSP Rau Qhov Kev Pabcuam Rau Cov Neeg Xiam Oob Qhab 250 Feem Pua Ua Haujlwm – Cov Neeg Laus​​ 
• MC 338 B (05/07) - Daim Ntawv Ua Haujlwm Xeem 250 Feem Pua ntawm Cov Nyiaj Tau Los rau 250 Feem Pua ntawm Cov Neeg Xiam Oob Qhab Ua Haujlwm-Menyuam Thov nrog lossis tsis muaj Niam Txiv uas tsis tsim nyog​​ 
• MC 338 C (05/07) – Daim Ntawv Ua Haujlwm Xeem Vaj Tse SSI/SSP Rau Qhov Kev Pab Cuam Rau Cov Neeg Xiam Oob Qhab Ua Haujlwm 250 Feem Pua – Cov Neeg Laus thiab Cov Menyuam Yaus Thov​​ 
  
• MC 338 J (05/07) – Premium Differential Work Sheet in the 250 Percent Working Disabled Program​​ 
  
• MC 354 (05/07) – Kev Hloov Kho Tshiab Txog Kev Sib Txuas Lus Nrog Medi-Cal​​ 
  Alt: Spanish
  ​​ 
• MC 355 (07/18) – Medi-Cal Request for Information​​ 
  
• Alt:​​  Arabic​​ ,​​  Armenian​​ ,​​  Qhab Meem teb​​ ,​​  Suav​​ ,​​  Farsi​​ ,​​  Hindi​​ ,​​  Hmoob​​ ,​​  Nyiv​​ ,​​  Kauslim​​ ,​​  Laotian​​ ,​​  Mien​​ ,​​  Punjabi​​ ,​​  Lavxias​​ ,​​  Spanish​​  ,​​  Tagalog​​ ,​​  Thaib​​ ,​​  Ukrainian​​ ,​​  Nyab Laj​​ 
• MC 356 (05/07) - Cov Lus Nug Txog Kev Kho Mob "Cab Rab Phom Rau Cov Menyuam Mos"​​ 
  Alt: Mev
  ​​ 
• MC 360 (06/07) – Kev Ceeb Toom Txog Kev Hloov Chaw Mus Rau Lwm Lub Nroog Medi-Cal​​ 
  
• MC 360 R (05/07) – Daim Ntawv Txais Nyiaj Rau Medi-Cal Intercounty Transfer Packet​​ 
  
• MC 363 (05/07) – Medi-Cal to Healthy Families Transmittal​​ 
  
• MC 363 S (05/07) – Cov Ntaub Ntawv Qhia Txog Lub Nroog​​ 
  
• MC 364 (05/07) – California Department of Aging (CDA) Waiver Referral​​ 
  
• MC 368 (06/07) (Chi) – Notice of Supplemental Form for Express Enrollment Applicants (Chinese)​​ 
  
• MC 368 (06/07) (Hmo) – Daim Ntawv Ceeb Toom Ntxiv Rau Cov Neeg Thov Sau Npe Sai (Hmoob)​​ 
  
• MC 368 (06/07) (Lavxias) – Daim Ntawv Ceeb Toom Ntxiv Rau Cov Neeg Thov Sau Npe Sai (Lavxias)​​ 
  
• MC 368 A (11/10) – Cov Lus Qhia Tseem Ceeb rau Cov Neeg Thov Medi-Cal​​ 
  Alt: Spanish
  ​​ 
• MC 368 M (06/07) – Daim Ntawv Sau Npe Ntxiv Rau Medi-Cal, Tsev Neeg Noj Qab Haus Huv thiab Cov Menyuam Noj Qab Haus Huv​​ 
  Alt: Spanish
  ​​ 
• MC 370 (06/13) – Daim Ntawv Thov Kev Pab Ua Ke Rau Tsev Neeg Noj Qab Haus Huv/Medi-Cal​​ 
• MC 371 (07/09) – Cov Tswv Cuab Ntxiv Hauv Tsev Neeg Thov Medi-Cal (Lus Askiv)
  Lwm Hom Lus: Arabic, Armenian, Suav, Farsi, Hmoob, Cambodian, Kauslim, Lavxias, Mev, Tagalog, Nyab Laj
  ​​ 
• MC 372 (12/21) – Kev Kho Mob Cancer Mis thiab Cervical Cancer (BCCTP) (Lus Askiv)
  Alt: Arabic, Armenian, Neeg Qhab Meem, Neeg Suav, Farsi, Hindi, Hmoob, Nyiv Pooj, Kauslim, Neeg Nplog, Mien, Lus Punjabi, Lus Lavxias, Lus Mev, Lus Tagalog, Thaib teb, Ukrainian, Nyab Laj​​ 
• MC 373 (12/21) – Kev Xa Mus Rau Lub Nroog Mus Rau Qhov Kev Pab Kho Mob Cancer Mis Thiab Cervical Cancer​​ 
  
• MC 380 (06/18) – Daim Ntawv Ceeb Toom Txog Kev Xaiv Tus Neeg Sawv Cev Uas Muaj Cai​​ 
  Lwm hom lus: Arabic, Armenian, Cambodian, Suav, Farsi, Hindi, Hmoob, Nyiv Pooj, Kauslim, Laotian, Mien, Punjabi, Lavxias teb sab, Mev, Tagalog, Thaib, Ukrainian, Nyab Laj ​​ 

• MC 381 (06/18) – Tsab Ntawv Tso Cai Rau Tus Neeg Sawv Cev​​ 
  Lwm hom lus: Arabic, Armenian, Cambodian, Suav, Farsi, Hindi, Hmoob, Nyiv Pooj, Kauslim, Laotian, Mien, Punjabi, Lavxias teb sab, Mev, Tagalog, Thaib, Ukrainian, Nyab Laj ​​ 

• MC 382 (06/18) – Daim Ntawv Xaiv Tus Neeg Sawv Cev Uas Muaj Cai​​ 
  Lwm hom lus: Arabic, Armenian, Cambodian, Suav, Farsi, Hindi, Hmoob, Nyiv Pooj, Kauslim, Laotian, Mien, Punjabi, Lavxias, Mev, Tagalog, Thaib, Ukrainian, Nyab Laj
  
  ​​ 
• MC 383 (06/18) – Authorized Representative Standard Agreement​​ 
  
  

Rov qab mus rau Forms Index​​