Medi-Cal Kev Tsim Nyog Kev Tsim Nyog Division Translated Forms: Tagalog

Rov qab mus rau Phau Ntawv Txhais Lus Lub Ntsiab

Cov ntaub ntawv Medi-Cal Kev Tsim Nyog Kev Tsim Nyog (MCED) cov ntawv teev npe hauv qab no, cov tsiaj ntawv, los ntawm tus lej thiab tau muab txhais ua Tagalog. 

PDF sau thiab luam cov ntawv tuaj yeem ua tiav hauv online thiab luam tawm rau cov ntawv tawv tawv kom kos npe thiab xa hauv lossis xa tuaj rau tus neeg ua haujlwm tsim nyog rau kev ua haujlwm. 

DHCS Forms: Tagalog

• DHCS 0001 (01/08) (Tag) – Cov pej xeem Asmeskas thiab cov neeg nyob hauv tebchaws uas thov Medi-Cal yuav tsum qhia pov thawj tias yog pej xeem thiab yog tus kheej
• DHCS 0002 (01/08) (Tag) - Pov Thawj Txog Kev Ua Neeg Amelikas Thiab Tus Kheej - Cov Kev Cai Tshiab Rau Cov Neeg Tau Txais Medi-Cal Uas Yog Neeg Amelikas Los Yog Neeg Hauv Tebchaws Meskas
• DHCS 0005 (02/08) (Tag) - Daim Ntawv Txais Cov Ntawv Pov Thawj Ua Neeg Amelikas lossis Daim Ntawv Qhia Tus Kheej
  
• DHCS 0007 (12/07) (Tag) - Cov Ntaub Ntawv Txog Kev Ua Neeg Amelikas Thiab Kev Txheeb Xyuas Tus Kheej Uas Txais Tau 
  
• DHCS 0008 (01/08) (Tag) - Cov Kev Cai Pov Thawj Txog Kev Ua Neeg Amelikas thiab Kev Txheeb Xyuas Tus Kheej rau Cov Menyuam Uas Yog Neeg Amelikas lossis Neeg Tebchaws Meskas Ua Tus Sau Cov Tsev Neeg Noj Qab Nyob Zoo 
• DHCS 0009 (09/07) (Tag) - Daim Ntawv Pov Thawj Qhia Txog Tus Kheej Rau Cov Neeg Xam Xaj Meskas lossis Cov Menyuam Yaus Hauv Tebchaws Uas Muaj Hnub Nyoog Qis Dua 18 Xyoo
• DHCS 0011 (06/08) (Tag) - Cov Ntawv Pov Thawj Txog Kev Ua Neeg Amelikas lossis Daim Ntawv Qhia Tus Kheej Uas Tau Txais 

 MC Forms: Tagalog

• MC 0021 (04/07) (Tag) – Medi-Cal to Healthy Families Bridging Consent Form
• MC 176 S (03/09) (Tag) – Medi-Cal Status Report
• MC 209 (05/12) (Tag) – Kev hloov pauv rau koj qhov kev pov hwm Medi-Cal thaum koj cev xeeb tub thiab tom qab koj yug me nyuam
• MC 210 RV (05/11) (Tag) – Medi-Cal Annual Redetermination
• MC 219 (11/15) (Tag) – Important Information For Persons Requesting Medi-Cal
• MC 223 C (06/11) (Tag) – Supplemental Statement of Facts for Medi-Cal Child Applicant Only
• MC 223 (10/09) (Tag) – Applicant’s supplemental statement of facts for Medi-Cal Adult Applicant Only 
• MC 239 DRA-6 (02/10) (Tag) - Daim Ntawv Ceeb Toom - Tsis Muaj Peev Xwm Txheeb Xyuas Tebchaws Meskas (US) Kev Ua Pej Xeem/Tus Kheej Los Ntawm Lub Chaw Haujlwm Saib Xyuas Kev Ruaj Ntseg Hauv Zej Zog
• MC 264 (09/11) (Tag) - Kev Tsim Nyog Rau Cov Poj Niam Cev Xeeb Tub Daim Ntawv Qhia Txog Tus Neeg Mob
• MC 371 (06/09) (Tag) – Additional Family Members Requesting Medi-Cal
• MC 372 (12/21) (Tag) – Breast and Cervical Cancer Treatment Program (BCCTP) Flyer
• MC 4035 (04/08) (Tag) – Medi-Cal Consent Form 

MC Cov Ntaub Ntawv Ceeb Toom: Tagalog

• MC Information Notice 003 (05/13) (Tag) – Early and Periodic Screening, Diagnosis, and Treatment Services