Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California

Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California

What Is Form DHCS6238A?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. The form may be used strictly within City of Sacramento. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DHCS6238A form?
A: DHCS6238A is a form used to request an amendment to protected health information in Sacramento Regional Office.

Q: What is the purpose of DHCS6238A form?
A: The purpose of DHCS6238A form is to request changes or amendments to protected health information.

Q: Who can use DHCS6238A form?
A: Any individual or their authorized representative can use the DHCS6238A form to request amendments to their protected health information.

Q: Can I request amendments to protected health information without using the DHCS6238A form?
A: No, the DHCS6238A form is required to request amendments to protected health information in the Sacramento Regional Office.

Q: Is there a fee for submitting a DHCS6238A form?
A: No, there is no fee for submitting the DHCS6238A form to request amendments to protected health information.

ADVERTISEMENT

Form Details:

  • Released on November 1, 2007;
  • The latest edition provided by the California Department of Health Care Services;
  • 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 DHCS6238A by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California

4.3 of 5 (23 votes)
  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California

    1

  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California, Page 2

    2

  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California, Page 3

    3

  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California, Page 1
  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California, Page 2
  • Form DHCS6238A Request to Amend Protected Health Information (Sacramento Regional Office) - City of Sacramento, California, Page 3
Prev 1 2 3 Next
ADVERTISEMENT

Related Documents