Form MC4035 Medi-Cal Consent Form - California (Korean)

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 Korean. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the MC4035 Medi-Cal Consent Form?
A: The MC4035 Medi-Cal Consent Form is a form used in California for individuals to give consent for the release of their medical information for Medi-Cal purposes.

Q: Who needs to fill out the MC4035 Medi-Cal Consent Form?
A: Any Medi-Cal recipient who wants to authorize the release of their medical information needs to fill out the MC4035 Medi-Cal Consent Form.

Q: Is the MC4035 Medi-Cal Consent Form available in Korean?
A: Yes, the MC4035 Medi-Cal Consent Form is available in Korean for individuals who prefer to fill out the form in that language.

Q: What information is required on the MC4035 Medi-Cal Consent Form?
A: The MC4035 Medi-Cal Consent Form requires the individual's name, date of birth, Medi-Cal ID number, the purpose of the release, and the start and end dates for the consent.

Q: How long is the MC4035 Medi-Cal Consent Form valid?
A: The MC4035 Medi-Cal Consent Form is valid for one year from the date of signature, unless otherwise specified.