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- Click ‘Get Form’ to open the DHCS 6207 form in the editor.
- Begin with Section I: Applicant/Provider Information. Fill in your legal name as reported to the IRS, and ensure all fields are completed without leaving any blank.
- Proceed to Section II if you are an unincorporated sole-proprietor or individual rendering provider. If applicable, provide your social security number and date of birth.
- In Section III, list all entities with a 5% or greater ownership interest. Be thorough and attach additional pages if necessary.
- Complete Sections IV through VIII as required, ensuring that all questions are answered accurately. Remember to sign the declaration page in ink.
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