Form CDPH8439 AIDS Drug Assistance Program Enrollment Application - California

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What Is Form CDPH8439?

This is a legal form that was released by the California Department of Public Health - 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 CDPH8439?
A: Form CDPH8439 is the AIDS Drug Assistance Program Enrollment Application in California.

Q: What is the AIDS Drug Assistance Program?
A: The AIDS Drug Assistance Program (ADAP) is a program in California that provides free or low-cost HIV/AIDS medications to eligible residents who are uninsured or have limited prescription drug coverage.

Q: Who is eligible for the ADAP in California?
A: To be eligible for the ADAP in California, individuals must meet certain criteria, such as being a resident of California, being HIV-positive, having a household income at or below a certain level, and being uninsured or having limited prescription drug coverage.

Q: What is the purpose of the Form CDPH8439?
A: The Form CDPH8439 is used to enroll in the AIDS Drug Assistance Program in California and provide necessary information to determine eligibility for the program.

Form Details:

Released on August 1, 2019;
The latest edition provided by the California Department of Public Health;
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 CDPH8439 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.