Dhcs 4073 - California Child Health And Disability Prevention (Chdp) Program Pre-Enrollment Application (Russian) - Health And Human Services Agency

ADVERTISEMENT

State of California—Health and Human Services Agency
Department of Health Care Services
Children’s Medical Services Branch
èêéÉêÄååÄ èêéîàãÄäíàäà áÑéêéÇúü à èêÖÑéíÇêÄôÖçàü àçÇÄãàÑçéëíà ì ÑÖíÖâ (CHDP)
áÄüÇãÖçàÖ é èêÖÑÇÄêàíÖãúçéâ êÖÉàëíêÄñàà
ì͇Á‡ÌËfl Ó‰ËÚÂβ ËÎË Ô‡ˆËÂÌÚÛ:
•
ÑÎfl ÚÓ„Ó ˜ÚÓ·˚ ÔÓÎÛ˜ËÚ¸ ‚ÓÁÏÓÊÌÓÒÚ¸ ·ÂÒÔ·ÚÌÓ„Ó Ï‰ˈËÌÒÍÓ„Ó ÓÒÏÓÚ ‡ Ò„ӉÌfl, ‚‡Ï ÌÂÓ·ıÓ‰ËÏÓ Á‡ÔÓÎÌËÚ¸ ‰‡ÌÌ˚È ·Î‡ÌÍ.
è ‰ÓÒÚ‡‚ÎflÂχfl ‚‡ÏË ËÌÙÓ Ï‡ˆËfl fl‚ÎflÂÚÒfl ÍÓÌÙˉÂ̈ˇθÌÓÈ. 옇ÒÚË ‚ ‰‡ÌÌÓÈ Ô Ó„ ‡ÏÏ fl‚ÎflÂÚÒfl ‰Ó· Ó‚ÓθÌ˚Ï.
ü‚ÎflÂÚÒfl ÎË Ô‡ˆËÂÌÚ ÎˈÓÏ Ï·‰¯Â 19 ÎÂÚ?
ч
çÂÚ
ì͇ÊËÚ ÍÓ΢ÂÒÚ‚Ó ˜ÎÂÌÓ‚ ‚‡¯ÂÈ ÒÂϸË.
$
$
ì͇ÊËÚ ‰ÓıÓ‰ ÒÂÏ¸Ë ‰Ó ‚˚˜ÂÚ‡ ̇ÎÓ„Ó‚.
ËÎË
Ç ÏÂÒflˆ
Ç „Ó‰
•
Ç˚ ËÎË ‚‡¯ ·ÂÌÓÍ ÏÓÊÂÚ ËÏÂÚ¸ Ô ‡‚Ó Ì‡ ÌÂÔ Â ˚‚ÌӠωˈËÌÒÍÓ ÒÚ ‡ıÓ‚‡ÌË ÔÓ Ô Ó„ ‡ÏÏ‡Ï Medi-Cal ËÎË Healthy
Families («á‰Ó Ó‚˚ ÒÂϸ˻).
ч
çÂÚ
ü ıÓ˜Û ÔÓ‰‡Ú¸ Á‡fl‚ÎÂÌËÂ Ó Ô Ó‰ÎÂÌËË Ô ËÓ‰‡ ÒÚ ‡ıÓ‚‡ÌËfl ÔÓ Ô Ó„ ‡ÏÏ‡Ï Medi-Cal ËÎË Healthy Families.
ÖÒÎË ‚˚ ÓÚ‚ÂÚËÎË «ÑÄ» ̇ ‰‡ÌÌ˚È ‚ÓÔ ÓÒ, ÙÓ Ï‡ Á‡fl‚ÎÂÌËfl ·Û‰ÂÚ ‚˚Ò·̇ ‚‡Ï ÔÓ ÔÓ˜Ú ˜Â ÂÁ ÌÂÒÍÓθÍÓ ‰ÌÂÈ. èÓʇÎÛÈÒÚ‡, ÓÚÔ ‡‚¸ÚÂ
Á‡ÔÓÎÌÂÌÌÓ Á‡fl‚ÎÂÌËÂ Í‡Í ÏÓÊÌÓ ·˚ÒÚ ÂÂ. ÖÒÎË Ì‡ ‰‡ÌÌ˚È ‚ÓÔ ÓÒ ‚˚ ÓÚ‚ÂÚËÎË «çÖí» (ËÎË ÂÒÎË ‚˚ ÓÚ‚ÂÚËÎË «ÑÄ», ÌÓ Ì ÓÚÔ ‡‚ËÎË
Á‡ÔÓÎÌÂÌÌÓ Á‡fl‚ÎÂÌËÂ), ÔÓÍ ˚ÚË ÒÚ ‡ıÓ‚˚ı ÛÒÎÛ„ ‰Îfl Ô‡ˆËÂÌÚ‡ ‚ ӷ·ÒÚË Ï‰ˈËÌ˚, ÒÚÓχÚÓÎÓ„ËË Ë ÓÙڇθÏÓÎÓ„ËË ·Û‰ÂÚ Ô ÂÍ ‡˘ÂÌÓ ‚
ÍÓ̈ ÒÎÂ‰Û˛˘Â„Ó ÏÂÒflˆ‡, ÂÒÎË ÑÂÔ‡ Ú‡ÏÂÌÚ ÒӈˇθÌÓ„Ó Ó·ÂÒÔ˜ÂÌËfl (Department of Social Services) ÓÍ Û„‡ Ì ÒÓÓ·˘ËÚ ‚‡Ï Ó· Ó· ‡ÚÌÓÏ.
чÌÌ˚ ԇˆËÂÌÚ‡
àÏÂÂÚ ÎË Ô‡ˆËÂÌÚ Í‡ ÚÓ˜ÍÛ-Û‰ÓÒÚÓ‚Â ÂÌË ¯Ú‡Ú‡ ä‡ÎËÙÓ ÌËfl ̇ ÔÓÎÛ˜ÂÌË θ„ÓÚ (Benefits
IdentificationCard, BIC) ËÎË Í‡ ÚÓ˜ÍÛ-Û‰ÓÒÚÓ‚Â ÂÌË ۘ‡ÒÚÌË͇ Ô Ó„ ‡ÏÏ˚ Medi-Cal?
ч
çÂÚ
ÖÒÎË ‰‡, Û͇ÊËÚ ÌÓÏ ͇ ÚÓ˜ÍË BIC (Ô Ë Ì‡Î˘ËË).
àÏfl Ô‡ˆËÂÌÚ‡ — î‡ÏËÎËfl
àÏfl
éÚ˜ÂÒÚ‚Ó
чڇ ÓʉÂÌËfl (ÏÂÒflˆ/‰Â̸/„Ó‰)
èÓÎ
çÓÏ ͇ ÚÓ˜ÍË ÒӈˇθÌÓ„Ó Ó·ÂÒÔ˜ÂÌËfl Ô‡ˆËÂÌÚ‡ (SSN) (Û͇Á˚‚‡Ú¸ Ì ӷflÁ‡ÚÂθÌÓ)
åÛÊÒÍÓÈ
ÜÂÌÒÍËÈ
ÖÒÎË ‚˚ fl‚ÎflÂÚÂÒ¸ ·ÂÁ‰ÓÏÌ˚Ï, ÔÓÒÚ‡‚¸Ú ÓÚÏÂÚÍÛ ‚ ‰‡ÌÌÓÏ ÔÛÌÍÚÂ. ì͇ÊËÚÂ Ô ËÏ ÌÓ ÏÂÒÚÓ Ô ÓÊË‚‡ÌËfl ‚ ÔÓÎÂ
«ÑÓχ¯ÌËÈ ‡‰ ÂÒ» Ë Á‡ÔÓÎÌËÚ ÔÓΠ«èÓ˜ÚÓ‚˚È ‡‰ ÂÒ».
ÑÓχ¯ÌËÈ ‡‰ ÂÒ
çÓÏ ͂‡ ÚË ˚
ÉÓ Ó‰
òÚ‡Ú
èÓ˜ÚÓ‚˚È Ë̉ÂÍÒ
éÍ Û„ Ô ÓÊË‚‡ÌËfl
èÓ˜ÚÓ‚˚È ‡‰ ÂÒ (ÂÒÎË Ì ÒÓ‚Ô‡‰‡ÂÚ Ò ‰Óχ¯ÌËÏ ‡‰ ÂÒÓÏ)
çÓÏ ͂‡ ÚË ˚
ÉÓ Ó‰
òÚ‡Ú
èÓ˜ÚÓ‚˚È Ë̉ÂÍÒ
àÏfl χÚÂ Ë — î‡ÏËÎËfl
àÏfl
éÚ˜ÂÒÚ‚Ó
ÖÒÎË ‚ÓÁ ‡ÒÚ Ô‡ˆËÂÌÚ‡ ÏÂÌ ӉÌÓ„Ó „Ó‰‡, ÔÓʇÎÛÈÒÚ‡, Á‡ÔÓÎÌËÚ ‰‡ÌÌ˚È ‡Á‰ÂÎ.
ÖÒÎË Â·ÂÌÍÛ Ì ËÒÔÓÎÌËÎÒfl Ó‰ËÌ „Ó‰, Ô ÓÊË‚‡Î ÎË ÓÌ Ò Ï‡Ú ¸˛ ‚ Ú˜ÂÌË ÏÂÒflˆ‡, ÍÓ„‰‡ ÓÌ ·˚Î ÓʉÂÌ?
ч
çÂÚ
чڇ ÓʉÂÌËfl χÚÂ Ë (ÏÂÒflˆ/‰Â̸/„Ó‰)
çÓÏ ͇ ÚÓ˜ÍË BIC ËÎË Medi-Cal ÎË·Ó ÌÓÏ ͇ ÚÓ˜ÍË ÒӈˇθÌÓ„Ó Ó·ÂÒÔ˜ÂÌËfl χÚ Ë
чÌÌ˚ ӉËÚÂÎfl/Á‡ÍÓÌÌÓ„Ó ÓÔÂÍÛ̇
àÏfl Ó‰ËÚÂÎfl/Á‡ÍÓÌÌÓ„Ó ÓÔÂÍÛ̇ ËÎË Ò‚Ó·Ó‰ÌÓ„Ó ÓÚ Ó‰ËÚÂθÒÍÓÈ
àÏfl
éÚ˜ÂÒÚ‚Ó
ÓÔÂÍË Â·ÂÌ͇, fl‚Îfl˛˘Â„ÓÒfl Ô‡ˆËÂÌÚÓÏ — î‡ÏËÎËfl
çÓÏ ‰Óχ¯ÌÂ„Ó ÚÂÎÂÙÓ̇
çÓÏÂ
‡·Ó˜Â„Ó ÚÂÎÂÙÓ̇
çÓÏ ÚÂÎÂÙÓ̇ ‰Îfl Ô ‰‡˜Ë ÒÓÓ·˘ÂÌËÈ
(
)
(
)
(
)
ç‡ Í‡ÍÓÏ flÁ˚Í ‚˚ ‡Á„Ó‚‡ Ë‚‡ÂÚ ‰Óχ?
ç‡ Í‡ÍÓÏ flÁ˚Í ‚˚ ÏÓÊÂÚ ˜ËÚ‡Ú¸ ÎÛ˜¯Â ‚Ò„Ó?
èӉڂ ʉÂÌËÂ
ü Ô Ó¯Û Ô Ó‚ÂÒÚË Ò„ӉÌfl ωˈËÌÒÍËÈ ÓÒÏÓÚ ÔÓ Ô Ó„ ‡ÏÏ CHDP. ü ÔӉڂ ʉ‡˛, ˜ÚÓ fl Ô Ó˜ËÚ‡Î Ë ÔÓÌflÎ ‰‡ÌÌ˚È ·Î‡ÌÍ. ü
Á‡fl‚Îfl˛, ˜ÚÓ Û͇Á‡Ì̇fl ÏÌÓÈ ËÌÙÓ Ï‡ˆËfl fl‚ÎflÂÚÒfl ‰ÓÒÚÓ‚Â ÌÓÈ, ÚÓ˜ÌÓÈ Ë ÔÓÎÌÓÈ.
èÓ‰ÔËÒ¸ Ó‰ËÚÂÎfl/ÓÔÂÍÛ̇ ËÎË Ò‚Ó·Ó‰ÌÓ„Ó ÓÚ Ó‰ËÚÂθÒÍÓÈ ÓÔÂÍË Â·ÂÌ͇
êÓ‰ÒÚ‚Ó Ò Ô‡ˆËÂÌÚÓÏ
чڇ
臈ËÂÌÚ ËÏÂÂÚ Ô ‡‚Ó ËÁÛ˜ËÚ¸ ‰ÓÍÛÏÂÌÚ˚, ÒӉ ʇ˘Ë „Ó/ ΢ÌÛ˛ ËÌÙÓ Ï‡ˆË˛. é „‡ÌËÁ‡ˆËÂÈ, ÓÚ‚ÂÚÒÚ‚ÂÌÌÓÈ Á‡ ı ‡ÌÂÌË ˝ÚÓÈ ËÌÙÓ Ï‡ˆËË,
fl‚ÎflÂÚÒfl ÑÂÔ‡ Ú‡ÏÂÌÚ Á‰ ‡‚ÓÓı ‡ÌÂÌËfl, Â„Ó ‡‰ ÂÒ: Department of Health Services, MS 8100, P.O. Box 997413, Sacramento, CA 95899-7413. äÓÔËfl
Department of Health Care Services
‰‡ÌÌÓ„Ó ·Î‡Ì͇ Ò Á‡ÔÓÎÌÂÌÌÓÈ ËÌÙÓ Ï‡ˆËÂÈ ÏÓÊÂÚ ·˚Ú¸ Ô Â‰ÓÒÚ‡‚ÎÂ̇ ÑÂÔ‡ Ú‡ÏÂÌÚÛ ÒӈˇθÌÓ„Ó Ó·ÂÒÔ˜ÂÌËfl ÚÓ„Ó ÓÍ Û„‡, ‚ ÍÓÚÓ ÓÏ ‚˚
Ô ÓÊË‚‡ÂÚÂ, Ë ·Û‰ÂÚ ı ‡ÌËÚ¸Òfl ‚ ωˈËÌÒÍÓÈ Í‡ Ú ‚‡¯Â„Ó Â·ÂÌ͇ Û ÔÓÒÚ‡‚˘Ë͇ ÛÒÎÛ„ ÔÓ Ô Ó„ ‡ÏÏ CHDP ‚‡¯Â„Ó Â·ÂÌ͇.
DHCS 4073 (Russian) (11/07)

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (hmong) - Health And Human Services Agency Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (hmong) - Health And Human Services Agency Legal
Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (chinese) - Health And Human Services Agency Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (chinese) - Health And Human Services Agency Legal
Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (armenian) - Health And Human Services Agency Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (armenian) - Health And Human Services Agency Legal
Form Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (korean) - Health And Human Services Agency Form Dhcs 4073 - California Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (korean) - Health And Human Services Agency Legal
Form Dhcs 4073 - Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (laotian) Form Dhcs 4073 - Child Health And Disability Prevention (chdp) Program Pre-enrollment Application (laotian) Legal
Form Dhcs 4073 - Child Health And Disability Prevention (chdp) Program Pre-enrollment Application Form Dhcs 4073 - Child Health And Disability Prevention (chdp) Program Pre-enrollment Application Legal
Dhcs 1737 County-owned And Operated Provider Self-survey Form - California - Health And Human Services Agency Dhcs 1737 County-owned And Operated Provider Self-survey Form - California - Health And Human Services Agency Legal
Application For A Child Care Center License - State Of California - Health And Human Services Agency Application For A Child Care Center License - State Of California - Health And Human Services Agency Legal
Dhcs 1807 Sp - California Autorizacion De Divulgacion De Informacion Protegida De La Salud E Informacion Confidencial - Health And Human Services Agency Dhcs 1807 Sp - California Autorizacion De Divulgacion De Informacion Protegida De La Salud E Informacion Confidencial - Health And Human Services Agency Legal
Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (korean) - Health And Human Services Agency Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (korean) - Health And Human Services Agency Legal

Related Categories

Parent category: Legal
Download
Go