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 PM161?
A: PM161 is a form used in California for the Confidential Referral/Follow-Up Report for the Child Health and Disability Prevention (CHDP) program.
Q: What is the CHDP program?
A: The Child Health and Disability Prevention (CHDP) program in California provides preventive health care services for low-income children and youth.
Q: What is the purpose of the PM161 form?
A: The PM161 form is used to refer and follow up on children who may be eligible for the CHDP program and in need of preventive health care services.
Q: Who uses the PM161 form?
A: The PM161 form is used by health care providers, schools, and other organizations to refer children to the CHDP program.
Q: Is the PM161 form confidential?
A: Yes, the PM161 form is considered confidential and contains sensitive information about the child's health and eligibility for the CHDP program.
Form Details:
Download a fillable version of Form PM161 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.