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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 CDPH8741
for the current year.
Form CDPH8741 Pre-exposure Prophylaxis Assistance Program (Prep-Ap) Provider Referral (Insured Clients Only) - California
What Is Form CDPH8741?
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 CDPH8741?
A: Form CDPH8741 is the Pre-exposure Prophylaxis Assistance Program (Prep-Ap) Provider Referral form for insured clients in California.
Q: What is the purpose of Form CDPH8741?
A: The purpose of Form CDPH8741 is to refer insured clients to providers for pre-exposure prophylaxis (Prep) assistance.
Q: Who can use Form CDPH8741?
A: Form CDPH8741 is for insured clients in California who need assistance with pre-exposure prophylaxis (Prep).
Q: What does the Pre-exposure Prophylaxis Assistance Program (Prep-Ap) do?
A: The Pre-exposure Prophylaxis Assistance Program (Prep-Ap) provides assistance to insured clients in accessing pre-exposure prophylaxis (Prep) services.
Q: Is Form CDPH8741 only for California residents?
A: Yes, Form CDPH8741 is specifically for insured clients in California.
Q: What information is required on Form CDPH8741?
A: Form CDPH8741 requires information such as client demographics, insurance information, provider information, and referral details.
Form Details:
- Released on May 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 CDPH8741 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
