ទម្រង់បកប្រែផ្នែកសិទ្ធិទទួលបាន Medi-Cal៖ ជនជាតិឡាវ
ត្រឡប់ទៅទំព័រមេនៃទម្រង់បកប្រែ
Medi-Cal Eligibility Division (MCED) forms are listed below, alphabetically, by form number and has been translated into Laotian.
PDF fill and print forms may be completed online and printed to hardcopy to be signed and mailed in or submitted in person to an eligibility worker for processing.
ទម្រង់ DHCS៖ ភាសាឡាវ
- DHCS 0001 (01/08) (Lao) – U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity
- DHCS 0002 (01/08) (Lao) – Proof of Citizenship and Identity–New Requirements for Medi-Cal Beneficiaries Who Are U.S. Citizens or Nationals
- DHCS 0005 (02/08) (Lao) – Receipt of Citizenship or Identity Documents
- DHCS 0007 (12/07) (Lao) – Acceptable Citizenship and Identity Documents
- DHCS 0008 (01/08) (Lao) – Proof of Citizenship and Identity Requirements — For Children Who Are U.S. Citizens or Nationals Filling Out the Healthy Families/Medi-Cal Joint Application
- DHCS 0009 (09/07) (Lao) – Affidavit of Identity for U.S. Citizen or National Children Under 18
- DHCS 0011 (06/08) (Lao) – Proof of Acceptable Citizenship or Identity Documents