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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DHCS6239
for the current year.
Form DHCS6239 Request to Amend Protected Health Information by Parent, Guardian or Personal Representative - California
What Is Form DHCS6239?
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 form DHCS6239?A: Form DHCS6239 is a request form to amend protected health information by a parent, guardian, or personal representative in the state of California.
Q: Who can use form DHCS6239?A: Form DHCS6239 can be used by parents, guardians, or personal representatives to request amendments to protected health information.
Q: What is the purpose of form DHCS6239?A: The purpose of form DHCS6239 is to allow parents, guardians, or personal representatives to request changes or corrections to protected health information.
Q: Is form DHCS6239 specific to California?A: Yes, form DHCS6239 is specific to the state of California.
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;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS6239 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form DHCS6239 Request to Amend Protected Health Information by Parent, Guardian or Personal Representative - California
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