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
41 - 50 of 50 forms
| Form Title | Topics |
|---|---|
| MC 5121AD - County-Direct Provider Approver Certification | Department Of Health Care Services, Drug Medi-Cal Treatment |
| MC 5123AD - DHCS Employee Approver Certification | Department Of Health Care Services, Drug Medi-Cal Treatment |
| MC 5400 (05/2013): Application for Certification of Special Treatment Program (STP) Services | Department Of Health Care Services, Mental Health |
| Military Consent for Release and Exchange of Information Form | Department Of Health Care Services, Nhsp, NHSP |
| NHSP Early Start Referral Form | Department Of Health Care Services, Nhsp, NHSP |
| Notice to Terminating Employees | Department Of Health Care Services, Health Insurance Premium Payment Online |
| Outpatient Screening Reporting | Department Of Health Care Services, Nhsp, NHSP |
| Privacy Complaint | Department Of Health Care Services, Privacy |
| Restrict Uses and Disclosures of PHI by Parent, Guardian or Personal Representative Request | Department Of Health Care Services, Privacy |
| Restrict Uses and Disclosures of PHI Request | Department Of Health Care Services, Privacy |
Contact Information & Office Locations
1 contact point
Main Office
Address:
P.O. Box 997413
MS 0000
Sacramento, CA 95899-7413
- (800) 541-5555
- (916) 636-1980