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 document used in California to request amendment of protected health information by a parent, guardian, or personal representative.

Q: Who can use Form DHCS6239?A: Form DHCS6239 can be used by parents, guardians, or personal representatives in California to request amendment of 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 to protected health information.

Q: What information is required on Form DHCS6239?A: Form DHCS6239 requires information such as the patient's name, date of birth, and a detailed description of the requested changes to the protected health information.

Q: What should I do with Form DHCS6239 once it is completed?A: Once completed, Form DHCS6239 should be submitted to the healthcare provider or the entity that maintains the protected health information.

Q: What happens after I submit Form DHCS6239?A: After submitting Form DHCS6239, the healthcare provider or entity will review the request and respond within a specific timeframe.

Q: Is there a fee for submitting Form DHCS6239?A: There is no fee for submitting Form DHCS6239 to request amendment of protected health information.

Q: Can I request an appeal if my request to amend protected health information is denied?A: Yes, if your request to amend protected health information is denied, you have the right to request an appeal.