Hla mus rau Cov Ntsiab Lus Tseem Ceeb
Qhib hom nkag tau yooj yim dua
Tua tawm hom siv tau ntau dua
Hla mus rau Cov Ntsiab Lus Tseem Ceeb
Medi-Cal Cov Tswv Cuab:
Khaws koj qhov kev pab them nqi kho mob
. Nkag mus rau
koj tus as-qhauj
lossis tiv tauj
koj lub nroog chaw ua haujlwm
kom hloov kho koj cov ntaub ntawv.
Tseem ceeb
Koj puas tau tso npe rau hauv Medi-Cal? Koj cov ntaub ntawv tiv tauj puas tau hloov pauv hauv ob xyoos dhau los? Muab koj lub nroog lub chaw lis haujlwm hauv koj lub nroog koj cov ntaub ntawv tiv tauj tshiab kom koj tuaj yeem nyob twj ywm.
Nrhiav koj lub county office.
Tsev
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Tsev
Hais txog DHCS
CA.gov
Ntawv qhia zaub mov
Nrhiav
Tsev
Kev pabcuam
Cov neeg
Cov kws kho mob &
Cov koom tes
Txoj Cai &
Kev cai
Cov ntaub ntawv &
Kev txheeb cais
Cov ntawv &
Kev tshaj tawm
Nrhiav
Nrhiav rau qhov chaw no:
Page Content
Forms: DHCS 6000
DHCS 6002 (06/16) - Daim Ntawv Thov Kev Pab Kho Mob Pib
DHCS 6011-1112 Direct Provider Narcotic Treatment Program - Cawv thiab Tshuaj
(Excel)
Alt:
Cov lus qhia
DHCS 6012-1112 Direct Provider Narcotic Treatment Program - Perinatal
(Excel)
Alt:
Cov lus qhia
DHCS 6204 (01/13) - Medi-Cal Daim Ntawv Thov Kev Pabcuam
DHCS 6207 (2/15) - Medi-Cal Cov Lus Qhia Tshaj Tawm
DHCS 6208 (Rev. 07/2025) Daim Ntawv Pom Zoo Tus Muab Kev Pab Medi-Cal
DHCS 6209 (12/14) - Medi-Cal Kev Hloov Ntxiv
DHCS 6217 (11/21) - Successor Liability with Joint and Several Liability Agreement
DHCS 6236 (Rev. 03/24) - Thov kom nkag mus rau cov ntaub ntawv tiv thaiv kev noj qab haus huv-Kev thov rau tus kheej
DHCS 6236 (Rev. 03/24) Spanish - Autorización Para La Divulgación De Información Médica Protegida
DHCS 6249 (08/19) - Teem Tus Neeg Sawv Cev - Cov Khoom Siv Rov Qab
DHCS 6251 (04/20) - Estate Recovery Questionnaire (Notice of Death)
DHCS 6251 (04/20) - Estate Recovery Questionnaire (Notice of Death) - Lus Mev
Rov qab mus rau Forms Index
Hnub hloov tshiab kawg: 7/15/2025 9:06 AM
