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加州醫療補助健康保健計劃資格部 (MCED) 表格按表格編號按字母順序列出如下，並已翻譯成越南語。 

PDF 填寫和列印表格可以在線填寫，並打印成紙本，以簽名並郵寄或親自提交給合資格工作人員進行處理。

DHCS 表格：越南語

• DHCS 0001 (01/08) (Vie) – U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity
• DHCS 0002 (01/08) (Vie) – Proof of Citizenship and Identity–New Requirements for Medi-Cal Beneficiaries Who Are U.S. Citizens or Nationals
• DHCS 0005 (02/08) (Vie) – Receipt of Citizenship or Identity Documents
• DHCS 0007 (12/07) (Vie) – Acceptable Citizenship and Identity Documents
• DHCS 0008 (01/08) (Vie) – Proof of Citizenship and Identity Requirements for Children Who Are U.S. Citizens or Nationals Filling Out the Healthy Families
• DHCS 0009 (09/07) (Vie) – Affidavit of Identity for U.S. Citizen or National Children Under 18
• DHCS 0011 (06/08) (Vie) – Proof of Citizenship or Identity Documents

MC 形式：越南語

• MC 0021 (04/07) (Vie) – Medi-Cal to Healthy Families Bridging Consent Form
• MC 176 S (03/09) (Vie) – Medi-Cal Status Report
• MC 209 (05/12) (Vie) – 懷孕期間及分娩後您的 Medi-Cal 保險範圍變更
• MC 210 RV (05/11) (Vie) – Medi-Cal Annual Redetermination
• MC 219 (11/15) (Vie) – Important Information for Persons Requesting Medi-Cal
• MC 223 C (06/11) (Vie) – Supplemental Statement of Facts for Medi-Cal Child Applicant Only – Under Age 18
• MC 223 (10/09) (Vie) – Applicant’s supplemental statement of facts for Medi-Cal Adult Applicant Only
• MC 239 DRA-6 (02/10) (Vie) – Information Notice – Unable to Verify United States (U.S.) Citizenship/Identity Through The Social Security Administration
• MC 264 (09/11) (Vie) – Presumptive Eligibility for Pregnant Women Program Patient Fact Sheet
• MC 371 (06/09) (Vie) – Additional Family Members Requesting Medi-Cal
• MC 372 (12/21) (Vie) – 乳癌與子宮頸癌治療計畫 (BCCTP) 宣傳單
• MC 4035 (04/08) (Vie) – Medi-Cal Consent Form

MC 信息通告：越南語

• MC Information Notice 003 (05/13) (Vie) – Early and Periodic Screening, Diagnosis, and Treatment Services