Form DHCS4488 New Referral Ccs / Ghpp Client Service Authorization Request (Sar) - California

Form DHCS4488 New Referral Ccs / Ghpp Client Service Authorization Request (Sar) - California

What Is Form DHCS4488?

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 the DHCS4488 form?
A: The DHCS4488 form is the New Referral CCS/GHPP Client ServiceAuthorization Request (SAR) form in California.

Q: What is the purpose of the DHCS4488 form?
A: The DHCS4488 form is used to request authorization for client services under the California Children's Services (CCS) or Genetically Handicapped Persons Program (GHPP).

Q: Who can use the DHCS4488 form?
A: The DHCS4488 form is used by healthcare providers to refer clients to the CCS or GHPP programs.

Q: What information is required on the DHCS4488 form?
A: The DHCS4488 form requires information about the client, the referring provider, the diagnosing provider, and the requested services.

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Form Details:

  • Released on September 1, 2015;
  • 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 DHCS4488 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS4488 New Referral Ccs / Ghpp Client Service Authorization Request (Sar) - California

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