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Original signed by Medical Eh161BlLlTY PROCEDURES MANUAL Effective June 1,2001, women seeking pregnancy-relatedJ services, whose income is at or below the 200 n o Percent Federal Poverty Level (GPL)

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1. Individuals who are applying for or renewing certain health care programs or services in California may need to fill out form 253 - dhcs ca.
2. This form is often required for eligibility determinations for programs such as Medi-Cal, the California Children's Services program, or other health care coverage options provided by the Department of Health Care Services (DHCS) in California.
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What is 253 - dhcs ca?

253 - dhcs ca is a form used for reporting certain information to the Department of Health Care Services in California.

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