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State of CaliforniaHealth and Human Services Agency California Department of Public Health MARK B HORTON, MD, MPH DirectorARNOLD SCHWARZENEGGER Governor September 7, 2010AFL 1027TO:Longer Care Facilities
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Obtain the necessary forms: Visit the Department of Health Services website or their office to collect the required paperwork.
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Complete personal information: Fill out your name, address, contact details, and any other necessary information as mentioned on the form.
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Provide medical history: Include details of any existing health conditions, medications, allergies, or treatments you have undergone.
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Attach supporting documents: Ensure you have all the necessary documents such as identification proof, income proof, insurance details, etc.
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Review and double-check: Before submitting the form, carefully review all the provided information to avoid any errors or omissions.
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Submit the application: Either mail the completed form along with supporting documents to the department's address or submit it in person at their office.
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Follow up: Keep track of your application and follow up with the department if required until you receive confirmation or any further instructions.

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The department of health services is a government agency responsible for overseeing public health concerns and ensuring the well-being of the community.
Healthcare providers, hospitals, clinics, and other healthcare facilities are required to file with the department of health services.
To fill out department of health services, healthcare providers must include information on patient demographics, medical services provided, and any infectious diseases reported.
The purpose of department of health services is to monitor public health trends, track outbreaks of diseases, and ensure the overall health and safety of the community.
Information such as patient demographics, diagnosis codes, treatment provided, and any infectious diseases must be reported on the department of health services.
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