Get the free CHDP Physician Assistant Application - County of Santa Barbara
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Child Health and Disability Prevention 345 Camino Del Remedy Santa Barbara, CA 93110 805/6815130 FAX 805/6814958CHDP Physician Application This application is for CHIP Physicians. Please refer to
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How to fill out chdp physician assistant application
How to fill out chdp physician assistant application
01
Step 1: Download the CHDP Physician Assistant Application form from the official website.
02
Step 2: Fill out your personal information accurately in the designated fields of the application form, including your name, address, phone number, and email.
03
Step 3: Provide your educational background, including the name of the institution, graduation date, and degree obtained. Include any relevant certifications or licenses.
04
Step 4: Document your work experience as a physician assistant, including the name of the employer, dates of employment, and a brief description of your responsibilities.
05
Step 5: Attach any supporting documents required, such as copies of your certifications and licenses.
06
Step 6: Review the completed application form to ensure all information is accurate and complete.
07
Step 7: Submit the application form by mail or electronically, as specified in the instructions.
08
Step 8: Await confirmation of receipt and further instructions from the CHDP program.
Who needs chdp physician assistant application?
01
Physician assistants who wish to participate in the CHDP (Child Health and Disability Prevention) program need to fill out and submit the CHDP Physician Assistant Application. This program aims to provide comprehensive health assessments and preventive services to children in California who are covered by Medi-Cal and low-income uninsured children. The application is required for physician assistants who want to become providers under the CHDP program and offer their services to eligible children.
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