Forms By Name – T (& U)
- 電信提供商和收費者申請/協議 (DHCS 4431)
- Transitional Medi-Cal (TMC) Quarterly Status Report (MC 176 TMC, 05/07)
Alt: Spanish (10/08) - Transmittal to CDCR Public Benefit Specialist on Determination of a Ward’s/Inmate’s Medi-Cal Eligibility (MC 0025, 03/10)
- 結核病 (TB) 計畫財務資格計畫表 - 合資格兒童與不符合資格的父母(MC 280 TB, 05/07)
- 結核病計劃收入資格工作表(MC 281 TB,05/07)
- 結核病計劃收入資格工作表(MC 282 TB,05/07)
- 結核病(TB)計劃屬性工作表成人(MC 278 TB,05/07)
- 結核病(TB)計劃屬性工作表兒童(MC 279 TB,05/07)
U
- U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity (DHCS 0001, 5/09)
Alt: Arabic , Armenian , Chinese , Farsi , Hmong , Cambodian , Korean , Laotian , Russian , Spanish , Tagalog , Vietnamese - 異常事故/傷害/死亡報告表格(DHCS 5079)