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 Neeg Asmeskas Cov Neeg Xam Xaj thiab Cov Neeg Qhab Asmeskas uas thov rau Medi-Cal Yuav tsum Qhia Ntawv Pov Thawj ntawm Neeg Xam Xaj thiab Tus Kheej​​ 
• DHCS 0002 (01/08) (Tag) - Cov Ntaub Ntawv Pov Thawj ntawm Kev Ua Neeg Xam Xaj thiab Tus Kheej - Cov Kev Cai Tshiab rau Cov Neeg Tau Txais Kev Pab Medi-Cal uas yog neeg xam xaj Asmeskas lossis haiv neeg​​ 
• DHCS 0005 (02/08) (Tag) - Tau txais cov ntaub ntawv pov thawj ntawm pej xeem los yog tus kheej​​ 
  
• DHCS 0007 (12/07) (Tag) - Cov ntaub ntawv lees paub ua pej xeem thiab tus kheej​​  
  
• DHCS 0008 (01/08) (Tag) - Cov ntaub ntawv pov thawj ntawm kev ua pej xeem thiab kev qhia txog tus kheej rau cov menyuam yaus uas yog neeg xam xaj Asmeskas lossis haiv neeg ua tiav Cov Tsev Neeg Noj Qab Haus Huv​​  
• DHCS 0009 (09/07) (Tag) - Daim ntawv pov thawj ntawm tus kheej rau US Citizen lossis National Children Under 18​​ 
• DHCS 0011 (06/08) (Tag) - Cov ntaub ntawv pov thawj lees paub tias yog neeg xam xaj lossis cov ntaub ntawv qhia txog tus kheej​​  

 MC Forms: Tagalog​​ 

• MC 0021 (04/07) (Tag) - Medi-Cal rau Healthy Families Bridging Consent Form​​ 
• MC 176 S (03/09) (Tag) - Medi-Cal Status Report​​ 
• MC 209 (05/12) (Tag) - Hloov pauv rau koj qhov kev pab cuam Medi-Cal thaum koj cev xeeb tub thiab tom qab yug me nyuam​​ 
• MC 210 RV (05/11) (Tag) - Medi-Cal Kev Txiav Txim Txhua Xyoo​​ 
• MC 219 (11/15) (Tag) - Cov Ntaub Ntawv Tseem Ceeb Rau Cov Neeg Thov Medi-Cal​​ 
• MC 223 C (06/11) (Tag) - Cov Lus Qhia Ntxiv Txog Qhov Tseeb Rau Medi-Cal Tus Neeg Thov Me Nyuam nkaus xwb​​ 
• MC 223 (10/09) (Tag) - Tus neeg thov daim ntawv qhia ntxiv ntawm qhov tseeb rau Medi-Cal Cov Neeg Laus Tsuas Yog​​  
• MC 239 DRA-6 (02/10) (Tag) - Daim Ntawv Ceeb Toom - Tsis Muaj Peev Xwm Txheeb Xyuas Tebchaws Meskas (Asmeskas) Kev Xam Xaj / Tus Kheej Los Ntawm Lub Chaw Saib Xyuas Kev Nyab Xeeb​​ 
• MC 264 (09/11) (Tag) - Presumptive Eligibility for Pregnant Women Program Patient Fact Sheet​​ 
• MC 371 (06/09) (Tag) - Cov Tsev Neeg Ntxiv Thov Medi-Cal​​ 
• MC 372 (12/21) (Tag) - Qhov Kev Pabcuam Kev Kho Mob Lub mis thiab Cervical Cancer (BCCTP) Flyer​​ 
• MC 4035 (04/08) (Tag) - Medi-Cal Daim Ntawv Pom Zoo​​  

MC Cov Ntaub Ntawv Ceeb Toom: Tagalog​​ 

• MC Cov Ntaub Ntawv Ceeb Toom 003 (05/13) (Tag) - Kev Tshuaj Ntsuam Xyuas Thaum Ntxov thiab Lub Sij Hawm, Kev Ntsuas, thiab Kev Kho Mob​​