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Form DHCS4073 Pre-enrollment Application - Child Health and Disability Prevention (Chdp) Program - California
What Is Form DHCS4073?
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 Form DHCS4073?
A: Form DHCS4073 is a Pre-enrollment Application for the Child Health and Disability Prevention (CHDP) Program in California.
Q: What is the CHDP Program?
A: The CHDP Program is a comprehensive health and wellness program for children in California.
Q: What is the purpose of Form DHCS4073?
A: The purpose of Form DHCS4073 is to apply for enrollment in the CHDP Program.
Q: Who is eligible for the CHDP Program?
A: Children in California who are under the age of 21 and meet certain income and residency requirements may be eligible for the CHDP Program.
Q: Are there any fees to apply for the CHDP Program?
A: No, there are no fees to apply for the CHDP Program.
Q: What documents do I need to include with Form DHCS4073?
A: You may need to include documents such as proof of income, proof of California residency, and your child's birth certificate or proof of legal guardianship.
Q: How long does it take to process the application?
A: Processing times may vary, but it typically takes a few weeks to process the application.
Q: What happens after my child is enrolled in the CHDP Program?
A: After your child is enrolled in the CHDP Program, they will have access to regular well-child check-ups, immunizations, and other preventive health services.
Form Details:
- Released on October 1, 2013;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS4073 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
