This version of the form is not currently in use and is provided for reference only. Download this version of Form CDPH8728 for the current year.
This is a legal form that was released by the California Department of Public Health - 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 CDPH8728 form?
A: The CDPH8728 form is the application form for the AIDS Drug Assistance Program (ADAP) Temporary Access Period (TAP) Request in California.
Q: What is ADAP?
A: ADAP stands for AIDS Drug Assistance Program. It is a program that provides access to HIV/AIDS medications for individuals who are uninsured or underinsured in California.
Q: What is TAP?
A: TAP stands for Temporary Access Period. It is a time-limited program that allows individuals in California to access HIV/AIDS medications while their eligibility for ADAP is being determined.
Q: Who is eligible for ADAP in California?
A: Individuals who are uninsured or underinsured, have a diagnosis of HIV/AIDS, and meet certain income and residency requirements may be eligible for ADAP in California.
Q: How do I request TAP in California?
A: To request TAP in California, you need to fill out and submit the CDPH8728 form, also known as the ADAP TAP Request form.
Q: What documents do I need to submit with the CDPH8728 form?
A: You may need to submit documentation such as proof of income, proof of residency, and medical documentation with the CDPH8728 form. The specific requirements may vary.
Q: What happens after I submit the CDPH8728 form?
A: After you submit the CDPH8728 form, your eligibility for TAP will be reviewed. If approved, you will be provided with temporary access to HIV/AIDS medications while your eligibility for ADAP is being determined.
Q: Can ADAP provide assistance with other HIV/AIDS related services?
A: Yes, ADAP may provide assistance with other HIV/AIDS related services such as case management, medication adherence support, and health insurance navigation in California.
Q: Is there an income limit to qualify for ADAP in California?
A: Yes, there is an income guideline for ADAP eligibility in California. The specific income limit may vary depending on household size and other factors.
Form Details:
Download a fillable version of Form CDPH8728 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.