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
- (800) 541-5555
- (916) 636-1980