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State of California Health and Human Services Agency Department of Health Care Services Medical Program MEDICAL CONSENT FORM County Return Address Notice Date: Case Number: Worker Name: Medical Recipient
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The state of California health refers to the overall well-being and medical conditions of residents of California.
All residents of California are required to file state of California health information.
To fill out state of California health information, residents can use online forms or visit local health departments for assistance.
The purpose of state of California health is to track and monitor the health status of residents in the state.
Information such as medical history, current health conditions, and any recent medical treatments must be reported on state of California health forms.
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