Tsev Cov Kev Pabcuam Cov Kev Xaiv Rau Kev Saib Xyuas Mus Ntev (Kev Xaiv Kev Pabcuam Hauv Tsev thiab Hauv Zej Zog) Cov Kev Cai Rau Daim Ntawv Thov Kev Pab Cuam Tus Kws Saib Xyuas Neeg Mob (INP)​​ 

Ib Tus Neeg Saib Xyuas Neeg Mob (INP) Daim Ntawv Thov Kev Pab​​ 

  • Daim Ntawv Thov Kev Pab Cuam Medi-Cal, DHCS 6204 (tsis tas yuav muaj neeg ua pov thawj)​​ 
  • Cov Lus Qhia Txog Kev Tshaj Tawm Medi-Cal, DHCS 6207 (tsis tas yuav muaj neeg ua pov thawj)​​ 
  • Daim Ntawv Cog Lus Muab Kev Pabcuam Medi-Cal, DHCS 6208 (tsis tas yuav muaj neeg ua pov thawj)​​ 
  • Cov Pov Thawj ntawm Lub Tebchaws Tus Neeg Muab Kev Pabcuam (NPI): NPPES NPI Registry Confirmation​​ 
  • Department of Consumer Affairs (DCA) Licence Printout​​ 
  • Siv tau State-Issued ID lossis Driver's License​​ 
  • Daim Ntawv Pov Thawj Txhawb Nqa Lub Neej Yooj Yim (BLS)​​ 
  • Kev lav phib xaub (kev ua tsis raug cai) kev pov hwm kev pov hwm​​ 
  • Rov pib dua. Piav qhia txog kev cob qhia thiab kev paub dhau los muab kev saib xyuas neeg mob rau cov neeg mob.​​ 
    Rau cov neeg thov LVN xwb: Muab lub npe ntawm tus RN uas yuav muab kev saib xyuas tas mus li, nrog rau tus lej daim ntawv tso cai ntawm RN.Rau cov neeg thov RN xwb: Muab cov sijhawm ua haujlwm rau txhua txoj haujlwm teev los ntawm tsib xyoos dhau los, piv txwv li, 40 teev hauv ib lub lis piam x 52 lub lis piam hauv ib xyoos = tag nrho cov sijhawm ua haujlwm hauv ib xyoos.​​ 

Xa daim ntawv thov ua tiav pob rau:​​ 

Department of Health Care Services​​ 

Integrated Systems of Care Division​​ 

Chaw Muab Npe Rau Npe​​ 

1501 Capitol Avenue, MS 4502​​ 

PO ib 997437​​ 

Sacramento, CA 95899-7437​​ 

THOV NCO NTSOOV: Xa pob khoom mus rau qhov chaw muab kev tso npe nkag​​ 

TSIS TXAUS SIAB TXOJ CAI TXOJ CAI NTAWM TUS TSWV TSEV KAWM NTAWV​​ 

Yog koj muaj lus nug txog cov cai ntawm daim ntawv thov, hu rau (916) 552-9105, xaiv 5, ces xaiv 2. Cov lus nug hauv email tuaj yeem xa mus rau WaiveProEnroll@dhcs.ca.gov.​​