Chuyển đến nội dung​​ 
Trang chủ CalAim: Chuyển đổi bản dịch biểu mẫu ASCMI Medi-Cal​​ 

Bản dịch biểu mẫu ASCMI​​ 

Quay lại trang CalAIM ASCMI Initiative​​ 

DHCS-0303 ASCMI Form AB 133
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese​​ 

DHCS-0309 ASCMI Form Non-AB 133
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese​​ 

DHCS-0310 ASCMI Revocation Form
Arabic, Armenian, Cambodian, Chinese-Simplified, Chinese-Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Laotian, Mien, Punjabi, Russian, Spanish, Tagalog, Thai, Ukrainian, Vietnamese​​