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 DHCS4496?
A: DHCS4496 is a form used for the American Indian Infant Health Initiative (Aiihi) Database in California.
Q: What is the American Indian Infant Health Initiative (Aiihi)?
A: The American Indian Infant Health Initiative (Aiihi) is a program in California aimed at improving the health outcomes of American Indian infants and their families.
Q: What is the purpose of the DHCS4496 form?
A: The purpose of the DHCS4496 form is to collect and document important health information about American Indian infants and their families for the Aiihi Database.
Q: Who is required to complete the DHCS4496 form?
A: Healthcare providers serving American Indian infants and their families in California are required to complete the DHCS4496 form.
Q: What information is collected on the DHCS4496 form?
A: The DHCS4496 form collects information such as demographic data, prenatal care, birth information, immunization history, and health screening results of American Indian infants.
Q: How is the DHCS4496 form used?
A: The DHCS4496 form is used to monitor the health status of American Indian infants, identify areas for improvement in healthcare services, and guide the Aiihi program in providing targeted interventions and support.
Q: Is the DHCS4496 form confidential?
A: Yes, the DHCS4496 form contains confidential health information and is subject to privacy laws and regulations to protect the privacy and confidentiality of individuals.
Q: Can I access the information in the Aiihi Database?
A: Access to the information in the Aiihi Database is strictly controlled to protect the privacy and confidentiality of individuals. Only authorized individuals involved in the Aiihi program have access to the information.
Q: Are American Indian infants outside of California eligible for the Aiihi program?
A: The Aiihi program is specific to California. However, other states may have similar programs aimed at improving the health outcomes of American Indian infants and their families.
Form Details:
Download a fillable version of Form DHCS4496 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.