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Completing the 18003226384 form online can simplify your submission process. This guide provides detailed, step-by-step instructions to ensure you accurately fill out all necessary sections of the form, making it accessible to all users.
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- Click ‘Get Form’ button to obtain the form and open it in the editor.
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- Next, move to the section designated for health information. This may include questions related to your medical history or specific health needs. Be thorough and precise in your responses.
- After filling out your health information, look for the dropdown menus or checkboxes related to services requested. Select the services applicable to you or the individual you are representing.
- Continue through the form, checking for any additional required documentation that may need to be uploaded or information that must be submitted alongside the form.
- Once you have completed all sections, review your responses for accuracy. Any errors may result in your form being returned for correction.
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Medi-Cal Rx ​Members and Providers: If you have a question, need help, or need to report a problem, please call (800) 977-2273 for our Medi-Cal Rx Customer Service Center (CSC)​.
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