PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form MC373
for the current year.
Form MC373 County Referral to the Breast and Cervical Cancer Treatment Program - California
What Is Form MC373?
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 MC373?
A: Form MC373 is a County Referral to the Breast and Cervical Cancer Treatment Program in California.
Q: What is the Breast and Cervical Cancer Treatment Program?
A: The Breast and Cervical Cancer Treatment Program is a program in California that provides treatment for eligible individuals diagnosed with breast or cervical cancer.
Q: How do I use Form MC373?
A: Form MC373 is used by a county health department to refer an individual to the Breast and Cervical Cancer Treatment Program.
Q: Who can use Form MC373?
A: Form MC373 can be used by county health departments in California to refer individuals who meet the eligibility criteria for the program.
Q: What are the eligibility criteria for the Breast and Cervical Cancer Treatment Program?
A: To be eligible for the program, individuals must be diagnosed with breast or cervical cancer, be uninsured or underinsured, meet income guidelines, and be a California resident.
Q: Is there a fee to use Form MC373?
A: No, there is no fee to use Form MC373.
Q: What happens after I submit Form MC373?
A: After you submit Form MC373, the county health department will review your application and determine if you meet the eligibility criteria for the program.
Q: Is the Breast and Cervical Cancer Treatment Program available in all counties in California?
A: Yes, the program is available in all counties in California.
Form Details:
- Released on September 1, 2009;
- 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 MC373 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
