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SAN DIMAS FAMILY CARE, INC. 1202PATIENT INFORMATION (PLEASE PRINT): NAME LASTFIRSTDATE OF BIRTH: SEX:MIDDLESOCIAL SECURITY NUMBER:MARITAL STATUS:DRIVER\'S LICENSE NUMBER: ()SINGLE()MARRIED(STATE:)WIDOWED()DIVORCEDPARENT
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01
Start by obtaining the necessary forms. These can usually be found on the San Dimas Family Care website or by contacting their office directly.
02
Fill out your personal information, including your name, address, and contact information.
03
Provide details about your family members who will also be covered by the care plan. This may include their names, ages, and any specific health concerns or conditions they may have.
04
Indicate your preferred method of payment for the care services. This may include providing insurance information or discussing payment plans with the San Dimas Family Care office.
05
Review your completed form for accuracy and completeness before submitting it.
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Submit your filled-out form as instructed by San Dimas Family Care. This may involve mailing it to their office or submitting it electronically through their website or email.
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Keep a copy of your completed form for your records in case any additional information or documentation is needed in the future.

Who needs san dimas family care?

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San Dimas Family Care is suitable for individuals and families who are in need of comprehensive healthcare services. This may include individuals of all ages, from infants to seniors, who require medical care, preventive screenings, vaccinations, ongoing treatment for chronic conditions, or even counseling services. San Dimas Family Care strives to serve the medical needs of a diverse range of individuals and families in the community.
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San Dimas Family Care is a community service program that provides support and resources for families in the San Dimas area, focusing on healthcare, wellness, and child care.
Individuals and families seeking assistance or benefits from the San Dimas Family Care program are typically required to file an application.
To fill out the San Dimas Family Care application, individuals must gather necessary information such as personal details, income, family size, and any relevant medical history, then follow the submission guidelines provided by the program.
The purpose of San Dimas Family Care is to provide support services to families, enhancing their quality of life through health programs, educational resources, and family-oriented activities.
Applicants must report personal identification information, family composition, income levels, and details regarding any specific health or social service needs.
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