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Form PM161 Chdp Confidential Referral / Follow-Up Report - California
What Is Form PM161?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is PM161?A: PM161 is a form used in California for the Confidential Referral/Follow-Up Report for the Child Health and Disability Prevention (CHDP) program.
Q: What is the CHDP program?A: The Child Health and Disability Prevention (CHDP) program in California provides preventive health care services for low-income children and youth.
Q: What is the purpose of the PM161 form?A: The PM161 form is used to refer and follow up on children who may be eligible for the CHDP program and in need of preventive health care services.
Q: Who uses the PM161 form?A: The PM161 form is used by health care providers, schools, and other organizations to refer children to the CHDP program.
Q: Is the PM161 form confidential?A: Yes, the PM161 form is considered confidential and contains sensitive information about the child's health and eligibility for the CHDP program.
Form Details:
- Released on September 1, 2007;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form PM161 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form PM161 Chdp Confidential Referral / Follow-Up Report - California
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