Sex age of child first 12. Client gender, if known: [yes, no or unknown] 13. Client type: [adopted, foster care, uninsured, public/private] 14. Client type address or zip code 1. Client age of child first 2. Client gender first 3. Client race first 4. Client citizenship first 5. Client income or family size first 6. Client source of income first 7. Client date of birth first 8. Client occupation (jobs in last 3 years (mm/dd/yr)...last 10 years, if known) 9. Client medical condition in last month 10. Client blood pressure in last month 11. Client weight in last month 12. Client history of illness in last month 13. Client current medications in last 6 months 14. Number of children seen in last 2 years [[Page 67464]] 15. Number of children seen in last 5 days 16. Number of children seen in last 1 month 17. Number of children seen in last 30 days 18. Date of last evaluation 20. Date of last dental treatment or orthodontic treatment on younger child 20. Date of last orthodontic treatment or dental treatment on older child 20. Age of child (mm/dd/yr) 30. Special circumstances in last 6 months 1. Is the child being treated for a mental health disorder?...yes 2. Is the child being treated for cancer?...yes 3. Is the child being treated for an eating disorder?...yes 4. Is the child being treated for an anxiety disorder?...yes 5. Is the child being treated for an intellectual disorder?...yes 6. Is the child being treated for ADHD or oppositional defiant disorder?...yes 7. Is the child being treated for depression?...
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Department of Health Care Services California Children s Services CCS State of California Health and Human Services Agency CCS DENTAL AND ORTHODONTIC CLIENT SERVICE AUTHORIZATION REQUEST SAR Provider Information 1.
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What is orthodontics for california children?
Orthodontics for California children refers to the dental treatment and correction of misaligned teeth and jaws in children residing in California. This treatment aims to improve their oral health, chewing ability, speech, and overall appearance.
Who is required to file orthodontics for california children?
Orthodontics for California children is not something that needs to be filed. It is a dental treatment provided by licensed orthodontists for children who require correction of their dental alignment and jaw issues.
How to fill out orthodontics for california children?
There is no specific form or document to fill out for orthodontics for California children. Parents or guardians need to find a licensed orthodontist, schedule an appointment, and undergo the necessary dental evaluations and treatments as recommended by the orthodontist.
What is the purpose of orthodontics for california children?
The purpose of orthodontics for California children is to correct dental alignment and jaw issues in order to improve their oral health, chewing ability, speech, and aesthetic appearance. It can also prevent future dental problems and enhance self-confidence.
What information must be reported on orthodontics for california children?
Orthodontics for California children does not require specific information to be reported. It is a dental treatment procedure conducted by licensed orthodontists for individual children based on their specific dental needs and requirements.
When is the deadline to file orthodontics for california children in 2023?
As mentioned earlier, orthodontics for California children does not involve any filing or specific deadline, as it is a dental treatment provided based on individual needs. Therefore, there is no deadline to file for orthodontics for California children in 2023 or any other year.
What is the penalty for the late filing of orthodontics for california children?
Since orthodontics for California children does not involve filing or reporting, there are no penalties for late filing. However, it is important for parents or guardians to adhere to the treatment plan and appointments as recommended by the orthodontist to ensure the effectiveness of the treatment.
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