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Form MC355 Medi-Cal Request for Information - California (Cambodian)
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.
The document is provided in Cambodian. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the MC355 Medi-Cal Request for Information?
A: The MC355 Medi-Cal Request for Information is a form used in California to request information related to Medi-Cal benefits.
Q: Who should use the MC355 form?
A: This form is specifically for individuals who speak Cambodian and need assistance or information about their Medi-Cal benefits.
Q: What information should I provide on the MC355 form?
A: The form asks for personal information such as your name, address, and Medi-Cal ID number. It also asks for details about the information or assistance you are requesting.
Q: How should I submit the completed MC355 form?
A: You can submit the completed form by mail or in person at your local county office.
Form Details:
- Released on July 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;
Download a fillable version of Form MC355 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form MC355 Medi-Cal Request for Information - California (Cambodian)
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