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 PM357 CHDP Referral?
A: The PM357 CHDP Referral is a form used in California for referring a child to the Child Health and Disability Prevention (CHDP) program.
Q: What is the CHDP program?
A: The Child Health and Disability Prevention (CHDP) program is a preventive health program in California that provides comprehensive health assessments and services for children from low-income families.
Q: Who can fill out the PM357 CHDP Referral form?
A: The PM357 CHDP Referral form can be filled out by healthcare providers, such as doctors or clinics, who identify a child that may benefit from the CHDP program.
Q: What information is required on the PM357 CHDP Referral form?
A: The PM357 CHDP Referral form requires information about the child's demographics, medical history, and reasons for the referral.
Form Details:
Download a printable version of Form PM357 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.