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State of California Health and Human Services Agency California Department of AgingAppendix 25A Initial Psychosocial Assessment Summary (Optional) Participant Name ___ SSP#___ Summarize current circumstances,
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The California health is a form used to report health information for residents of California.
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All residents of California are required to file the California health form.
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The California health form can be filled out online or by mail with the required health information.
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Information such as medical history, current health conditions, and healthcare provider details must be reported on the California health form.
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