Home Forms, Laws, and Publications Forms Medi-Cal Eligibility Division Translated Forms: Korean

Medi-Cal Eligibility Division 翻訳フォーム: 韓国語

Medi-Cal Eligibility Division(MCED)フォームは、アルファベット順、フォーム番号順に以下にリストされており、韓国語に翻訳されています。

PDFの記入および印刷フォームは、オンラインで記入し、ハードコピーに印刷して署名し、郵送するか、処理のために適格労働者に直接提出することができます。

DHCSフォーム:韓国語

DHCS 0001 (01/08) (Kor) – U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity
DHCS 0002 (01/08) (Kor) – Proof of Citizenship and Identity–New Requirements for Medi-Cal Beneficiaries Who Are U.S. Citizens or Nationals
DHCS 0005 (02/08) (Kor) – Receipt of Citizenship or Identity Documents
DHCS 0007 (12/07) (Kor) – Acceptable Citizenship and Identity Documents
DHCS 0008 (01/08) (Kor) – Proof of Citizenship and Identity Requirements for Children Who Are U.S. Citizens or Nationals Filling Out the Healthy Families
DHCS 0009 (09/07) (Kor) – Affidavit of Identity for U.S. Citizen or National Children Under 18
DHCS 0011 (06/08) (Kor) – Proof of Acceptable Citizenship or Identity Documents

MC 0021 (04/07) (Kor) – Medi-Cal to Healthy Families Bridging Consent Form
MC 176 S (03/09) (Kor) – Medi-Cal Status Report
MC 209 (05/12) (Kor) – Changes to your Medi-Cal coverage during your pregnancy and after you give birth
MC 210 RV (05/11)(Kor) – Medi-Cal Annual Redetermination
MC 219 (11/15) (Kor) – Important Information for Persons Requesting Medi-Cal
MC 223 C (06/11) (Kor) – Supplemental Statement of Facts for Medi-Cal Child Applicant Only – Under Age 18
MC 223 (10/09) (Kor) – Applicant’s supplemental statement of facts for Medi-Cal Adult Applicant Only
MC 239 DRA-6 (02/10) (Kor) – Information Notice – Unable to Verify United States (U.S.) Citizenship/Identity Through The Social Security Administration
MC 264 (09/11) (Kor) – Presumptive Eligibility for Pregnant Women Program Patient Fact Sheet
MC 371 (06/09) (Kor) – Additional Family Members Requesting Medi-Cal
MC 372 (12/21) (Kor) – Breast and Cervical Cancer Treatment Program (BCCTP) Flyer
MC 4035 (04/08) (Kor) – Medi-Cal Consent Form

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