Form DHCS4509 Established Ccs / Ghpp Client Service Authorization Request (Sar) - California

Form DHCS4509 Established Ccs / Ghpp Client Service Authorization Request (Sar) - California

What Is Form DHCS4509?

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 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).

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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 DHCS4509 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS4509 Established Ccs / Ghpp Client Service Authorization Request (Sar) - California

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