健康保險保費繳付網上表格
感謝您造訪健康保險保費支付（HIPP）專案線上表格頁面。 要開始您的 HIPP 申請，請填寫 HIPP 申請表和以下所有表格。 但是，委任代表表格是選擇性的，並不需要確定資格。
英文版
西班牙文版
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