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State of California Health and Human Services Agency Department of Health Care Services Children s Medical Services Branch CHILD HEALTH AND DISABILITY PREVENTION (CHIP) PROGRAM PRE-ENROLLMENT APPLICATION
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Instructions to Fill Out Form to Form Parent:

01
Start by carefully reading the instructions provided with the form. Make sure you understand the purpose of the form and the information you need to provide.
02
Begin by entering your personal information in the designated sections. This may include your full name, address, date of birth, and contact details. Follow the format specified in the instructions.
03
If applicable, provide information about your current parental status. This may include details about any existing children or legal guardianship agreements.
04
Next, carefully fill out the required information related to the other parent. This may include their full name, address, contact details, and their relation to the child.
05
Provide any necessary information about the child involved, such as their full name, date of birth, and any relevant identification numbers.
06
Make sure to include any additional information or details that are specifically requested by the form. This may include providing supporting documents or answering specific questions.
07
Review your form for accuracy and completeness. Ensure that all fields have been filled out correctly and that you have not missed any required information.
08
If required, sign and date the form in the designated sections. Follow any additional instructions regarding witness signatures or notarization if applicable.

Who Needs Instructions to Form Parent?

01
Individuals who are seeking legal recognition as a parent, such as through adoption or custody proceedings.
02
Anyone who needs to establish legal rights and responsibilities related to parenting a child.
03
Those who are going through a divorce or separation and need to provide documentation regarding their parental role.
04
Individuals who are involved in co-parenting arrangements or sharing custody of a child.
05
Any person who is looking to establish their parental status officially for any legal or administrative purposes.
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Instructions to form parent is a document providing guidance on how to establish legal parentage.
Anyone seeking to establish legal parentage must file instructions to form parent.
Instructions to form parent can typically be filled out online or by completing a paper form with relevant information.
The purpose of instructions to form parent is to provide a clear process for establishing legal parentage.
Instructions to form parent may require information about the biological parents, child, and any supporting documentation.
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