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State of California Health and Human Services Agency Department of Health Services Children s Medical Services Branch CHILD HEALTH AND DISABILITY PREVENTION (CHIP) PROGRAM PRE-ENROLLMENT APPLICATION
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How to fill out child health and disability:

01
Gather all necessary information about the child's health and disabilities, including medical records, diagnoses, and treatment plans.
02
Fill out the required forms accurately and completely, providing all relevant information about the child's condition, symptoms, and limitations.
03
Attach any supporting documentation, such as medical reports or assessments, to substantiate the child's health and disability claims.
04
Double-check all the information provided before submitting the application to ensure its accuracy and completeness.

Who needs child health and disability:

01
Children with chronic illnesses or disabilities that require ongoing medical care and support.
02
Families with children who have developmental or cognitive disabilities that affect their daily functioning or ability to participate in activities.
03
Individuals who believe their child may be eligible for additional support, services, or benefits due to their health or disability condition.
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Child health and disability is a program that provides support and assistance to children with health issues or disabilities.
Parents or legal guardians of children with health issues or disabilities are required to file child health and disability.
To fill out child health and disability, you need to provide relevant information about the child's health condition or disability and complete the required forms or paperwork.
The purpose of child health and disability is to ensure that children with health issues or disabilities receive the necessary support and services to promote their well-being and development.
The information that must be reported on child health and disability includes details about the child's health condition or disability, any medical diagnoses or treatments, and any support or services the child is receiving or needs.
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