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How to use or fill out California Health Care Services with our platform
- Click ‘Get Form’ to open the California Health Care Services Agreement in the editor.
- Complete the Preamble by entering your county name and department/agency name in the designated fields.
- Fill out Section XX with the signatory information, ensuring that the name and title of the signatory are printed or typed clearly.
- Modify the Header of the Agreement to include the appropriate Agreement Number, replacing 'XX' with your two-digit county code.
- Ensure that two copies of the completed Agreements are prepared, both containing original signatures from an authorized official.
- Include a contact name, telephone number, email address, and street address for communication purposes when sending Agreements to DHCS.
- Submit all signed Agreements by August 26, 2019, to ensure compliance with submission guidelines.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.8 Satisfied (118 Votes) |
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