This version of the form is not currently in use and is provided for reference only. Download this version of Form DHCS6238 for the current year.
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.
Q: What is the DHCS6238 form?
A: The DHCS6238 form is a request form used in California to amend Protected Health Information.
Q: What is Protected Health Information?
A: Protected Health Information (PHI) refers to any information that can be used to identify an individual and relates to their health or healthcare.
Q: Why would I need to amend Protected Health Information?
A: You may need to amend Protected Health Information if there are errors or inaccuracies in your health records.
Q: What information do I need to provide when filling out the DHCS6238 form?
A: You will need to provide your personal information, details of the information you want to amend, and a reason for the requested amendment.
Q: Who can submit the DHCS6238 form?
A: The DHCS6238 form can be submitted by the individual whose Protected Health Information is being requested to be amended or by their authorized representative.
Q: Is there a fee for submitting the DHCS6238 form?
A: No, there is no fee for submitting the DHCS6238 form.
Q: What happens after submitting the DHCS6238 form?
A: After submitting the DHCS6238 form, the healthcare provider will review the request and make a determination regarding the requested amendment.
Q: What if my request to amend Protected Health Information is denied?
A: If your request is denied, you have the right to submit a written statement of disagreement, which will be included in your health records.
Form Details:
Download a fillable version of Form DHCS6238 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.