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Get Ca Dhcs Pm100 2007
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How to fill out the CA DHCS PM100 online
The CA DHCS PM100 is an essential form used for the annual reporting of hearing testing conducted in schools. This guide provides a clear, step-by-step process for completing this form online, ensuring all necessary information is accurately submitted.
Follow the steps to complete the CA DHCS PM100 effectively.
- Click ‘Get Form’ button to access the CA DHCS PM100 online form. This will allow you to open the form and begin filling it out.
- Complete the identifying information at the top of the form. This includes the reporting school year, the CDS code number (which identifies your county and district), and the period covered by the testing.
- In Column (1), indicate the highest grade available in your district by checking the appropriate box.
- In Column (2), enter the number of pupils enrolled in each grade as of the October report submitted to the California Department of Education.
- For Column (3), provide the number of pupils who were screened in each grade according to Section 2951(c), CCR, Title 17.
- In Column (4), specify the number of pupils who failed both threshold tests per Section 2951(d), CCR, Title 17.
- In Column (5), enter the number of pupils referred for medical and/or audiological evaluation based on the results from Column (4).
- In Column (6), detail the number of pupils examined by a doctor and/or audiologist or currently under treatment, according to the data in Column (5).
- Include a brief description in the 'Special education' section, highlighting the audiometric, audiological, and medical services utilized for pupils requiring special education.
- Select the appropriate boxes that describe the testing personnel and, if relevant, indicate any authorized agencies involved in the testing.
- Review your completed form for accuracy before submitting it as required. Ensure that all copies are distributed correctly as specified on the form.
Start completing your CA DHCS PM100 online today to ensure timely submission.
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The primary insurance program under California DHCS is called Medi-Cal. Medi-Cal offers comprehensive health coverage to eligible residents, including low-income families and individuals. Understanding the CA DHCS PM100 structure can help you better access these essential health services.
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