This version of the form is not currently in use and is provided for reference only. Download this version of Form CDPH8739 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 Form CDPH8739?
A: The Form CDPH8739 is a Pre-exposure Prophylaxis Assistance Program (PreP-AP) provider referral form.
Q: What is the Pre-exposure Prophylaxis Assistance Program (PreP-AP)?
A: The Pre-exposure Prophylaxis Assistance Program (PreP-AP) is a program in California that provides assistance for accessing Pre-exposure Prophylaxis (PrEP) medication.
Q: What is the purpose of the Form CDPH8739?
A: The purpose of the Form CDPH8739 is to refer individuals to providers who can assist them in accessing Pre-exposure Prophylaxis (PrEP) medication through the Pre-exposure Prophylaxis Assistance Program (PreP-AP).
Q: Who can use the Form CDPH8739?
A: The Form CDPH8739 can be used by individuals who are seeking assistance in accessing Pre-exposure Prophylaxis (PrEP) medication through the Pre-exposure Prophylaxis Assistance Program (PreP-AP).
Form Details:
Download a fillable version of Form CDPH8739 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.