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 Tagalog. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the Form DHCS4073?
A: The Form DHCS4073 is the 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 a program in California that provides preventive health and dental services to eligible children.
Q: Who is eligible for the CHDP Program?
A: Children from low-income families who meet certain eligibility requirements are eligible for the CHDP Program.
Q: What services does the CHDP Program provide?
A: The CHDP Program provides a range of preventive health and dental services, including check-ups, immunizations, vision and hearing tests, and dental screenings.
Q: How do I apply for the CHDP Program?
A: You can apply for the CHDP Program by completing the Form DHCS4073 and submitting it to the appropriate office.
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.