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.
Q: What is the DHCS4509 form?
A: The DHCS4509 form is the Client Service Authorization Request (SAR) form for the California Children's Services (CCS) and Genetically Handicapped Persons Program (GHPP).
Q: What does the DHCS4509 form do?
A: The DHCS4509 form is used to request authorization for services for clients enrolled in the California Children's Services (CCS) and Genetically Handicapped Persons Program (GHPP).
Q: Who uses the DHCS4509 form?
A: Healthcare providers and clients enrolled in the California Children's Services (CCS) and Genetically Handicapped Persons Program (GHPP) use the DHCS4509 form.
Q: Is the DHCS4509 form specific to California?
A: Yes, the DHCS4509 form is specific to California and is used for services provided by the California Children's Services (CCS) and Genetically Handicapped Persons Program (GHPP).
Form Details:
Download a fillable version of Form DHCS4509 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.