DSHS Form 4073 Pre-enrollment Application - Child Health and Disability Prevention (Chdp) Program - California (Lao)

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.

The document is provided in Lao. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 4073?
A: DSHS Form 4073 is a pre-enrollment application for the Child Health and Disability Prevention (CHDP) program in California.

Q: What is the CHDP program?
A: The CHDP program stands for Child Health and Disability Prevention program. It provides preventive health care services to eligible children in California.

Q: What is the purpose of the pre-enrollment application?
A: The pre-enrollment application (DSHS Form 4073) is used to gather information about the child's health and eligibility for the CHDP program.

Q: Who can apply for the CHDP program?
A: Parents or legal guardians of eligible children can apply for the CHDP program.

Q: What information is required on the DSHS Form 4073?
A: The DSHS Form 4073 requires information about the child's personal details, medical history, and household income.

Q: Is there a fee to enroll in the CHDP program?
A: No, there is no fee to enroll in the CHDP program. It is a free program for eligible children in California.

Q: What services are covered by the CHDP program?
A: The CHDP program covers a range of preventive health care services, including physical exams, immunizations, dental screenings, vision and hearing tests, and developmental assessments.