This version of the form is not currently in use and is provided for reference only. Download this version of Form DHCS6236 for the current year.
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.
Download a fillable version of Form DHCS6236 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.