Foomamka

Hoos waxaa ku taxan dhammaan foomamka loo baahan yahay ee aad u baahan tahay si aad isugu qorto ama u cusbooneysiiso dheefahaaga Carewell. Foomamka waxaa lagu abaabulaa waxtar ama qayb.

Xulo faa'iido ama qayb si aad u aragto foomamka

Ilkaha

Aragti + Maqal

Progam Caawinta Shaqaalaha

Caawinta Qiimaha Daryeelka Caafimaadka

Qorshayaasha La Ansixiyay
Medicare ahaan

Waqtiga Lacagta La Bixiyo

Muhiim - Macluumaadkaaga cusbooneysii

Cusbooneysii Macluumaadkaaga

Step 1 of 5

Magaca*
Marka hore
Dhexe
*
Ugu Dambeeyay

Cinwaanka Guriga*
Street Address Guri / Suite / Kale City State ZIP Code

Cinwaanka boostada*
La mid ah cinwaanka Guriga

Street Address Guri / Suite / Kale City State ZIP Code

Lambarka Sooshiyaal Sikiyuuriti*
Taariikhda Dhalashada*
Qaabka Taariikhda: MM slash DD slash YYYY
Jinsiga*

Email*
Luqaddaada Aad Jeceshahay*
Telefoon*

Si aad xaq ugu yeelatid dheefaha Carewell, Xafiiska Maamulka Gargaarka Waa inuu lahaadaa magacaaga, jinsigaaga, Lambarka Sooshiyaal Sikiyuuritiga, taariikhda dhalasho iyo cinwaanka hadda kujira faylka. Sidoo kale waa inaad hubisaa inay macluumaadkaagu la socdaan Gobolka. Xusuusin: Gudbinta macluumaadkan waxay awood u siineysaa Xafiiska Maamulka ee Macaashka inuu kugu qoro ceymiska Carewell SEIU 503 Ilkaha, Aragtida + Maqalka iyo Barnaamijka Caawinta Shaqaalaha haddii aad xaq u leedahay.

U gudbi foomka kore si aad ugu cusbooneysiiso macluumaadkaaga Xafiiska Maamulka Faa'iidooyinka
Raac tilmaamaha hoose si aad ugu cusbooneysiiso macluumaadkaaga shaqsiyeed Gobolka iyadoo kuxiran nooca shaqaalaha aad tahay.

Shaqaalaha Daryeelka Guriga (HCW)

Cusboonaysii cinwaankaaga xafiiska deegaanka ee APD / AAA. Isuduwaha / Karaaniga HCW ee deegaanka waa qofka ku haboon inuu la xiriiro.

Shaqaalaha Taageerada Shakhsi ahaaneed ee ODDS (PSW)

Buuxi foomkan Isbeddelka Macluumaadka (PDF) si loo hubiyo in DHS ay hayso macluumaadkaaga hadda ku jira faylka.

Shaqaalaha Taageerada Shakhsiyeed ee OHA (PSW)

Buuxi Foomkan Cusboonaysiinta Macluumaadka Bixiyaha (PDF) si aad u hubiso in OHA ay macluumaadkaaga hadda ku jiraan faylka. Ku buuxi dhammaan qaybaha foomka marka laga reebo kuwan:

“Qeybtaan ugu buuxi urur, koox ama wakaalad”
"Koodhka taksiga ayaa isbeddelaya"

Ilkaha

Foomka Ka Dhaafida Faa'iidooyinka

Foomka Dijitaalka A

Foomka Dib-u-eegista iyo Racfaanka

Foomka Dijital ah B

Waa in lagu soo gudbiyaa warqad sharaxeysa sababta aad u codsaneyso rafcaan.

Aragti + Maqal

Foomka Dib-u-eegista iyo Racfaanka

Foomka Dijitaalka ah D
Waa in lagu soo gudbiyaa warqad sharaxeysa sababta aad u codsaneyso rafcaan.

Foomka Lacag Bixinta Xubinta ee VSP

Foomka PDF C

Barnaamijka Caawinta Shaqaalaha

Foomka Ka Dhaafida Faa'iidooyinka

Foomka Dijital ah E

Foomka Dib-u-eegista iyo Racfaanka

Foomka Dijital ah F

Waa in lagu soo gudbiyaa warqad sharaxeysa sababta aad u codsaneyso rafcaan.

Caawinta Qiimaha Daryeelka Caafimaadka

Qorshayaasha La Ansixiyay

2020 Warqad Sanadeed: Gudaha Agagaarka Adeegga Kaiser

Foomka Dijital ah GG

2020 Annual Paperwork: Outside the Kaiser Service Area

Foomka Dijital ah GGG

Foomka Diiwaanka Guud ee 2020

Foomka Dijital ah ee G

Foomka 2020 HIPPA

Foomka Dijitaalka ah H

2020 Kaiser Permanente: Wakiilka Foomka Diiwaanka

Foomka Dijital ah ee I

Foomka Bayaan ee 2020

Foomka Dijital ah J

Foomka Lacag Bixinta Ameriflex

Foomka PDF D

Foomka Caawinta Iskaashatada Beesha

Foomka Dijital ah K

Oggolaanshaha Fasaxa Foomka

Foomka Dijital ah L

Buuxi tan haddii aad u baahan tahay inaad u oggolaato xubin qoyska ka mid ah ama saaxiib aad ku kalsoon tahay inuu su'aalo weydiiyo, ballan qabsado ama xaqiijiyo macluumaadka isagoo magacaaga ku hadlaya.