• 患者病史记录(DHCS 4015 U, 01/08)​​ 
• 患者治疗记录（MC 2946，09/07）​​ 
• 护理机构护理水平工作表的不合格期限（MC 176 PI，05/07）​​ 
• Personal Rights – Alcohol Recovery and Drug Treatment Facilities (DHCS 5080)
  Alt: Spanish (DHCS 5080SP)​​ 
• Pickle 符合资格者财务资格工作表——符合资格的儿童，但父母不符合资格（DHCS 7019，05/07）​​ 
• 腌制需求测试(DHCS 7075, 05/07)​​ 
• 泡菜资源工作表(DHCS 7037, 05/07)
  ​​ 
• 250% 工作残疾人计划中的保费差异工作表(MC 338 J, 05/07)​​ 
• （MC 264, 09/11）
  Alt：阿拉伯语、亚美尼亚语、中文、波斯语、苗语、柬埔寨语、韩语、俄语、西班牙语、他加禄语、越南语
  ​​ 
• 精神健康康复中心计划灵活性表格(DHCS 1012, 12/22)
  ​​ 
• 精神病健康机构计划灵活性表格(DHCS 1013, 12/22)
  ​​ 
• Proof of Acceptable Citizenship or Identity Documents (DHCS 0011, 6/08)
  Alt: Arabic , Armenian , Chinese , Farsi , Hmong , Cambodian , Korean , Laotian , Russian , Spanish , Tagalog , Vietnamese ​​ 
• 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 0008，1/08）​​ 
  
• Alt: Arabic , Armenian , Chinese , Farsi , Hmong , Cambodian , Korean , Laotian , Russian , Spanish , Tagalog , Vietnamese ​​ 
• Proof of Citizenship and Identity–New Requirements for Medi-Cal Beneficiaries who are U.S. Citizens or Nationals (DHCS 0002, 1/08)
  Alt: Arabic , Armenian , Chinese , Farsi , Hmong , Cambodian , Korean , Laotian , Russian , Spanish , Tagalog , Vietnamese ​​ 
• Property Assessment Statement of Facts (MC 210 PA, 05/07)
  Alt: Spanish​​ 
• 财产留置权转介(DHCS 7014, 06/07)​​ 
• 财产储备工作表(MC 176 P, 05/07)
  ​​ 
• Property Worksheet/Assessment for Institutionalized Spouses (Eng/Sp) (MC 176 PA-1/PA-2, 05/07)
  Alt: Spanish​​ 
• 提供商数据表（PM 177）​​ 
• 提供方电子数据交换（PEDI）账户申请（DHCS 4517, 05/13）​​ 
• Provider Electronic Data Interchange (PEDI) Domain Update – DHCS 4518 (DHCS 4518, 05/13)​​ 
  

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