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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 CDPH8742
for the current year.
Form CDPH8742 Pre-exposure Prophylaxis Assistance Program (Prep-Ap) Provider Referral (Kaiser Permanente Clients Only) - California
What Is Form CDPH8742?
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 Form CDPH8742?
A: Form CDPH8742 is a document for the Pre-exposure Prophylaxis Assistance Program (Prep-Ap) Provider Referral for Kaiser Permanente Clients in California.
Q: Who is eligible for the Prep-Ap program?
A: The Prep-Ap program is available for Kaiser Permanente Clients in California.
Q: What is the purpose of the Prep-Ap program?
A: The Prep-Ap program provides assistance for pre-exposure prophylaxis (PrEP) to prevent HIV in eligible individuals.
Q: What is the function of this form?
A: This form is used to refer Kaiser Permanente Clients to participating providers for the Prep-Ap program.
Q: Is the Prep-Ap program available to non-Kaiser Permanente clients?
A: No, the Prep-Ap program is only available for Kaiser Permanente Clients in California.
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 CDPH8742 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
