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Form DHCS5020 Guarantor Agreement - California
What Is Form DHCS5020?
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 the DHCS5020 Guarantor Agreement?
A: The DHCS5020 Guarantor Agreement is a form used in California to establish a person as a guarantor for the medical care and treatment of a patient.
Q: Who needs to fill out the DHCS5020 Guarantor Agreement?
A: The DHCS5020 Guarantor Agreement should be filled out by someone who is willing to take responsibility for the payment of medical expenses for a patient.
Q: Is the DHCS5020 Guarantor Agreement legally binding?
A: Yes, the DHCS5020 Guarantor Agreement is a legally binding agreement between the guarantor and the healthcare provider.
Q: What are the responsibilities of a guarantor under the DHCS5020 Guarantor Agreement?
A: The guarantor is responsible for paying any outstanding medical expenses not covered by insurance for the patient.
Q: Can a guarantor be held responsible for someone else's medical bills?
A: Yes, the guarantor agrees to be financially responsible for the patient's medical expenses, even if they are not the patient themselves.
Form Details:
- Released on March 1, 2017;
- 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 DHCS5020 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
