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 Cambodian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form MC223 C?
A: Form MC223 C is the Supplemental Statement of Facts for Medi-Cal Child Applicant Only - Under Age 18.
Q: Who is this form for?
A: This form is for Medi-Cal child applicants who are under the age of 18.
Q: What is the purpose of Form MC223 C?
A: The purpose of Form MC223 C is to provide additional information about the child applicant for Medi-Cal.
Q: Is this form specific to a certain state?
A: Yes, this form is specific to the state of California.
Q: Is this form available in multiple languages?
A: Yes, Form MC223 C is available in the Cambodian language.
Form Details:
Download a printable version of Form MC223 C by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.