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Form DHCS4026 Incidental Medical Services Certification Form - Health Care Practitioner Client Assessment - California
What Is Form DHCS4026?
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 purpose of the DHCS4026 form?
A: The DHCS4026 form is used to certify that a health care practitioner has assessed a client for incidental medical services.
Q: Who needs to fill out the DHCS4026 form?
A: Health care practitioners who provide incidental medical services in California need to fill out this form.
Q: What are incidental medical services?
A: Incidental medical services refer to the non-medical services that are provided by health care practitioners in licensed residential facilities in California.
Q: Do I need any specific qualifications to fill out this form?
A: Yes, you must be a qualified health care practitioner authorized to assess clients for incidental medical services.
Q: Are there any fees associated with submitting this form?
A: There are no fees associated with submitting the DHCS4026 form.
Q: Is it mandatory to fill out this form?
A: Yes, it is mandatory for health care practitioners providing incidental medical services in California to fill out this form.
Q: How often do I need to fill out the DHCS4026 form?
A: The DHCS4026 form needs to be filled out initially and then renewed every two years.
Form Details:
- Released on June 1, 2016;
- 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 DHCS4026 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
