Form DHCS6237A Request to Access Protected Health Information by Parent, Guardian or Legal Representative (Genetically Handicapped Persons Program) - City of Sacramento, California

Form DHCS6237A Request to Access Protected Health Information by Parent, Guardian or Legal Representative (Genetically Handicapped Persons Program) - City of Sacramento, California

What Is Form DHCS6237A?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. The form may be used strictly within City of Sacramento. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DHCS6237A?
A: DHCS6237A is a form used to request access to protected health information for individuals enrolled in the Genetically Handicapped Persons Program (GHPP) in the City of Sacramento, California.

Q: Who can use Form DHCS6237A?
A: Parents, guardians, or legal representatives of individuals enrolled in the GHPP in the City of Sacramento, California can use Form DHCS6237A to request access to protected health information.

Q: What is the purpose of Form DHCS6237A?
A: The purpose of Form DHCS6237A is to request access to protected health information for individuals enrolled in the GHPP in the City of Sacramento, California.

Q: Do I need to be a resident of Sacramento, California to use Form DHCS6237A?
A: Yes, Form DHCS6237A is specific to individuals enrolled in the GHPP in the City of Sacramento, California.

Q: Is there a fee to submit Form DHCS6237A?
A: There is no fee mentioned for submitting Form DHCS6237A. However, additional fees may apply for obtaining the requested protected health information.

Q: Is there an expiration date for Form DHCS6237A?
A: There is no specific expiration date mentioned for Form DHCS6237A. It is recommended to submit the form in a timely manner.

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Form Details:

  • Released on November 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;

Download a fillable version of Form DHCS6237A by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS6237A Request to Access Protected Health Information by Parent, Guardian or Legal Representative (Genetically Handicapped Persons Program) - City of Sacramento, California

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