Daim Ntawv Qhia Tshuaj Ua Ntej Tso Cai lossis Kauj Ruam Kev Kho Mob Exception Request Form
Siv daim foos no los xa cov ntawv sau tshuaj ua ntej tso cai thov rau Alliance Care IHSS cov tswv cuab. Fax rau MedImpact ntawm (858) 790-7100. Yog muaj lus nug, hu rau MedImpact ntawm (800) 788-2949.
Rau cov ntawv sau tshuaj ua ntej thov kev tso cai rau cov tswv cuab Medi-Cal, xa mus rau www.Medi-CalRx.dhcs.ca.gov.
Nias daim duab nram qab no los qhib daim ntawv PDF:
Hu rau Pharmacy Department
Tus Xov Tooj: 831-430-5507
Tus Xov Tooj Xa Ntawv (Fax): 831-430-5851
Hnub Monday-hnub Friday, 8 a.m. txog 5 p.m.