Forms By Name – N (& O)
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- 叙述表(MC 2320, 09/07)
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针对残疾工人的 Medi-Cal 新计划:250% 工作残疾计划(MC 338 传单,05/07)。
- Alt:西班牙语
- New Referral CCS/GHPP Client Service Authorization Request (SAR) (DHCS 4488, 11/07)
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新生儿转介(非加州医疗保险申请表(可填写) (MC 330, 01/15)
- Alt:西班牙语
- Notice of Certification for Intensive Treatment Pursuant to Section 5250 (14 DaysIntensive Treatment) or 5270.15 (Additional 30 Days Intensive Treatment for Grave Disability) of the Welfare and Institutions Code (DHCS 1808, 05/24)
- Notice of Certification for Intensive Treatment Pursuant to Section 5250 (14 DaysIntensive Treatment) or 5270.15 (Additional 30 Days Intensive Treatment for Grave Disability) of the Welfare and Institutions Code (Spanish) (DHCS 1808 SP, 07/2024)
- 快速入学申请者补充表格通知(中文) (MC 368, 06/07) (中文)
- 快速入学申请人补充表格通知(苗族) (MC 368, 06/07)(Hmo)
- 快速入学申请人补充表格通知(俄语) (MC 368, 06/07,(俄语)
- 关于保险公司、代理商和经纪人分发 Medi-Cal 资格标准的通知(DHCS 7102, 01/13)
- Alt:西班牙语
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关于加州医疗保险资格标准的通知(DHCS 7077, 07/2022)
- Notice Regarding Transfer of a Home for both a Married and an Unmarried Applicant/Beneficiary (Eng/Sp) (DHCS 7077 A, 05/07)
- Medi-Cal 跨县转移通知(MC 360,06/07)
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