Department of Health Care Services (DHCS)

Official Website: https://www.dhcs.ca.gov

​The mission of the Department of Health Care Services (DHCS) is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services and long-term care. The vision is to preserve and improve the overall health and well-being of all Californians.

Forms & Documents

Browse all Department of Health Care Services (DHCS) government forms

21 - 40 of 50 forms

Form Title Topics
DHCS 1808 (MH 1760): Notice of Certification Department Of Health Care Services, Mental Health
DHCS 1809 (MH 1761): Notice of Certification for Additional 14 Days Intensive Treatment Department Of Health Care Services, Mental Health
DHCS 1811 (MH 5671): Authorization for Release of Patient Information Department Of Health Care Services, Mental Health
DHCS 1812 (MH 5756): Voluntary Admission Application for Mentally Disabled Person Department Of Health Care Services, Mental Health
DHCS 1813 (11/2013) / MH8001/95: Application for Licensure Mental Health Rehabilitation Center (MHRC Department Of Health Care Services, Mental Health
DHCS 1815 (11/2013): Application for a Special Permit of Structured Outpatient Services (SOPS Department Of Health Care Services, Mental Health
DHCS 3131 (04/18) Application for Mental Health Program Approval Short-Term Residential Therapeutic Programs (STRTP Department Of Health Care Services, Mental Health
DHCS 5260 Form - SUDCRS Approver Form Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6065A Form - Good Cause Certification Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6065A Instructions - Good Cause Certification Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6065B Form - Good Cause Certification Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6065B Instructions - Good Cause Certification Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6700 Form - Multiple Billing Override Certification Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 6700 Instructions - Multiple Billing Override Certification Instructions Department Of Health Care Services, Drug Medi-Cal Treatment
DHCS 8049 Form - County Certification of Compliance Department Of Health Care Services, Drug Medi-Cal Treatment
Diagnostic Audiologic Evaluation Reporting Department Of Health Care Services, Nhsp, NHSP
GEMT Point of Contact Department Of Health Care Services, Medi-Cal Ground Emergency Medical Transportation Supplemental Reimbursement
GEMT Provider Participation Agreement Department Of Health Care Services, Medi-Cal Ground Emergency Medical Transportation Supplemental Reimbursement
Infant Reporting Department Of Health Care Services, Nhsp, NHSP
MC 5120AD - Vendor Approver Certification Department Of Health Care Services, Drug Medi-Cal Treatment

Contact Information & Office Locations

1 contact point

Main Office

Address:
P.O. Box 997413
MS 0000
Sacramento, CA 95899-7413

Phone numbers:
  • (800) 541-5555
  • (916) 636-1980

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