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 DHCS6245A?
A: DHCS6245A is a form for requesting an accounting of disclosures of protected health information for the Genetically Handicapped Persons Program in California.
Q: Who can use the DHCS6245A form?
A: The DHCS6245A form can be used by a parent, guardian, or legal representative of a participant in the Genetically Handicapped Persons Program in California.
Q: What is the purpose of the DHCS6245A form?
A: The purpose of the DHCS6245A form is to request information about the disclosures of protected health information made by the Genetically Handicapped Persons Program in California.
Q: Is there a fee for submitting the DHCS6245A form?
A: No, there is no fee for submitting the DHCS6245A form.
Form Details:
Download a fillable version of Form DHCS6245A by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.