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Form DHCS4073 Pre-enrollment Application - Child Health and Disability Prevention (Chdp) Program - California (Hmong)
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.
The document is provided in Hmong. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the DHCS4073 Form?A: The DHCS4073 Form is a pre-enrollment application for the Child Health and Disability Prevention (CHDP) Program in California.
Q: What is the CHDP Program?A: The CHDP Program is the Child Health and Disability Prevention Program, which provides free preventive health evaluations and services for low-income children and youth in California.
Q: Who is eligible for the CHDP Program?A: Low-income children and youth in California are eligible for the CHDP Program.
Q: What is the purpose of the DHCS4073 Form?A: The DHCS4073 Form is used to apply for enrollment in the CHDP Program and provide necessary information about the child's health and disability history.
Q: Is the DHCS4073 Form available in Hmong language?A: Yes, the DHCS4073 Form is available in Hmong language to accommodate Hmong-speaking individuals in California.
Form Details:
- Released on October 1, 2013;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
Download a printable version of Form DHCS4073 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
