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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 CDPH8722
for the current year.
Form CDPH8722 Health Insurance Premium Payment Assistance Programs Partial Payment Agreement - AIDS Drug Assistance Program (Adap) - California
What Is Form CDPH8722?
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 CDPH8722 form?
A: The CDPH8722 form is a Health Insurance Premium Payment Assistance Programs Partial Payment Agreement.
Q: What does the CDPH8722 form cover?
A: The CDPH8722 form covers the AIDS Drug Assistance Program (ADAP).
Q: What is the purpose of the CDPH8722 form?
A: The purpose of the CDPH8722 form is to provide partial payment assistance for health insurance premiums.
Q: Who can use the CDPH8722 form?
A: The CDPH8722 form is for residents of California who are enrolled in the ADAP program.
Q: What does the ADAP program in California provide?
A: The ADAP program in California provides assistance for purchasing HIV/AIDS drugs and related health care services.
Form Details:
- Released on June 1, 2018;
- 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 CDPH8722 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
Download Form CDPH8722 Health Insurance Premium Payment Assistance Programs Partial Payment Agreement - AIDS Drug Assistance Program (Adap) - California
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