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This Form is used for revoking a Special Power of Attorney in the state of California.
This Form is used for requesting enrollment in the California AIDS Drug Assistance Program.
This document is a form for claiming medical expenses paid by the client from health insurance assistance programs in California. It is written in Spanish.
This Form is used for documenting the responsibilities of the OA-Hipp client in California.
This Form is used for reporting incidents in the California Adap Enrollment System.
This document is for the Programa De Pago De Prima De Seguro De Salud Acuerdo De Pago Parcial - Programa De Asistencia Para Medicamentos Contra El Sida in California. (Spanish)
This form is used for creating a Special Power of Attorney in California. It allows someone to grant specific powers to another person to act on their behalf in legal matters.
This form is used for summarizing information related to outbreaks of gastroenteritis in California. It helps gather data and provide a summary of the outbreak details.
This form is used for submitting information related to the California Rabies Strain Typing and Species Identification Project. It helps to identify and categorize the different strains of rabies found in California.
This form is used for submitting the results of a rabies examination in California.
This Form is used for applying to serve on an advisory committee in California.
This form is used for individuals in California who want to register for Phase I Training but are currently on the waiting list.
This Form is used for healthcare providers and clinicians to apply for enrollment in California's professional guidance program.
This form is used for filing a complaint in the state of California. It gathers necessary information about the complaint to be filed.
This form is used for individuals and institutions in California who wish to keep and use laboratory animals. It is an application for approval and must be completed fully and accurately.
This form is used for requesting access to personal information in California.
This form is used for requesting access to personal information by a parent, guardian, or personal representative in the state of California.
This form is used for requesting an accounting of disclosures of personal information by a parent, guardian, or personal representative in California. It helps individuals track the use and disclosure of their personal information.
This form is used for requesting information on the disclosure of personal information in the state of California.
This form is used for requesting to amend personal information in the state of California.
This document is used for requesting to amend personal information by a parent, guardian, or personal representative in the state of California.
This form is used for authorizing the use and disclosure of personal information in the state of California.
This form is used to request confidential communication in California.
This form is used for filing a privacy or HIPAA complaint in the state of California. It allows individuals to report violations of their privacy rights or the Health Insurance Portability and Accountability Act (HIPAA).
This form is used for requesting confidential communication of personal information by a parent, guardian, or personal representative in California.
This document is used for requesting a regulation notice in the state of California.
This form is used for requesting to restrict the use and disclosure of personal information by a parent, guardian, or personal representative in California.
This form is used for requesting to restrict the use and disclosure of personal information in the state of California.
This Form is used for verifying radon certification in the state of California.
This form is used for ensuring compliance with anti-entrapment device and system regulations in public pools and spas in California. It helps pool and spa owners and operators in California to document their compliance with safety standards for preventing entrapment incidents.