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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 DHCS5267
for the current year.
Form DHCS5267 Provider Information Management System (Pims) County Approver Certification & Vendor Appointment Form - California
What Is Form DHCS5267?
This is a legal form that was released by the California Department of Health Care Services - 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 DHCS5267 Provider Information Management System (Pims) County Approver Certification & Vendor Appointment Form?
A: The DHCS5267 is a form used in California for county approvers to certify and appoint vendors for the Provider Information Management System (Pims).
Q: Who uses the DHCS5267 form?
A: County approvers in California use the DHCS5267 form.
Q: What is the purpose of the DHCS5267 form?
A: The purpose of the DHCS5267 form is to certify and appoint vendors for the Provider Information Management System (Pims) in California.
Q: What information is required on the DHCS5267 form?
A: The DHCS5267 form requires information such as the vendor's name, address, contact information, and certifications.
Q: Is the DHCS5267 form specific to certain counties in California?
A: No, the DHCS5267 form is used statewide by county approvers in California.
Q: How often do vendors need to be certified using the DHCS5267 form?
A: Vendors need to be certified using the DHCS5267 form annually or as required by the jurisdiction.
Q: Can the DHCS5267 form be submitted electronically?
A: Yes, the DHCS5267 form can be submitted electronically or in paper format.
Q: What happens after the DHCS5267 form is submitted?
A: After the DHCS5267 form is submitted, it will be reviewed and processed by the county approver.
Q: Are there any fees associated with the DHCS5267 form?
A: No, there are no fees associated with the DHCS5267 form.
Form Details:
- Released on October 1, 2018;
- 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 DHCS5267 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
