健康保险费支付网络表格
感谢您访问健康保险费支付（HIPP）计划在线表格页面。 要开始您的 HIPP 申请，请填写HIPP 申请表和下面列出的所有表格。 然而，代表任命表格是可选的，并且不是确定资格的必要条件。
英文版本
西班牙语版本
Other Languages – HIPP Application Form DHCS 6172
Armenian Version – HIPP Application Form
Cambodian Version – HIPP Application Form
Chinese Version – HIPP Application Form
Farsi Version – HIPP Application Form
Hmong Version – HIPP Application Form
Japanese Version – HIPP Application Form
Korean Version – HIPP Application Form
Laos Version – HIPP Application Form
Mien Version – HIPP Application Form
Punjabi Version – HIPP Application Form
Russian Version – HIPP Application Form
Tagalog Version – HIPP Application Form
Taiwanese Version – HIPP Application Form
Ukranian Version – HIPP Application Form
Vietnamese Version – HIPP Application Form