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This version of the form is not currently in use and is provided for reference only. Download this version of
Form STD696
for the current year.
Form STD696 Dental Plan Direct Payment Authorization - California
What Is Form STD696?
This is a legal form that was released by the California Department of General 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 Form STD696 for?
A: Form STD696 is used for dental plandirect payment authorization in California.
Q: Who can use Form STD696?
A: Form STD696 can be used by individuals who have a dental plan in California.
Q: What is dental plan direct payment authorization?
A: Dental plan direct payment authorization allows the dental plan to pay the dental provider directly for covered services.
Q: Is Form STD696 mandatory?
A: The use of Form STD696 is not mandatory, but it is recommended to ensure timely payment of dental services.
Form Details:
- Released on May 1, 2008;
- The latest edition provided by the California Department of General 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 STD696 by clicking the link below or browse more documents and templates provided by the California Department of General Services.
Download Form STD696 Dental Plan Direct Payment Authorization - California
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