Form HBD-34 Disabled Dependent Member Questionnaire and Medical Report - Health and / or Dental Benefits - California

What Is Form HBD-34?

This is a legal form that was released by the California Public Employees' Retirement System - 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 Form HBD-34?
A: Form HBD-34 is a Disabled Dependent Member Questionnaire and Medical Report used for Health and/or Dental Benefits in California.

Q: Who can use Form HBD-34?
A: Form HBD-34 can be used by disabled dependent members who need to provide information for health and/or dental benefits in California.

Q: What information does Form HBD-34 require?
A: Form HBD-34 requires disabled dependent members to provide information about their disability and medical history.

Q: How should I fill out Form HBD-34?
A: You should fill out Form HBD-34 accurately and completely, providing all required information about your disability and medical history.

Q: Are there any fees associated with Form HBD-34?
A: No, there are no fees associated with Form HBD-34.

Q: What should I do after filling out Form HBD-34?
A: After filling out Form HBD-34, you should submit the form to the appropriate healthcare provider or the California Health and Human Services Agency.