Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California

Notification Icon 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.

Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California

What Is Form CDPH8728?

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.

FAQ

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.

ADVERTISEMENT

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the California Department of Public Health;
  • 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 CDPH8728 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.

Download Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California

4.4 of 5 (79 votes)
  • Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California

    1

  • Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California, Page 2

    2

  • Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California, Page 1
  • Form CDPH8728 AIDS Drug Assistance Program (Adap) Temporary Access Period (Tap) Request - California, Page 2
Prev 1 2 Next
ADVERTISEMENT

Related Documents