Santa Clara County Government Forms

Form Title	Agency	Topics
Loan Modification Settlement Stipulation and Order	Superior Court
Long-Term Care Authorization Form	Health Plan
Long-Term Care Authorization Form FAQs	Health Plan
Long-Term Care Authorization Form FAQs	Health Plan
Long-Term Care Discharge Notification Form	Health Plan
LTSS Training Attestation	Health Plan
Mailing Address Change	Assessor
Map and Property Characteristics Requests	Assessor
Medi-Cal/Healthy Kids Member Grievance Form (	Health Plan
Medi-Cal/Healthy Kids Member Grievance Form (English	Health Plan
Medi-Cal/Healthy Kids Member Grievance Form (Espanol	Health Plan
Medi-Cal/Healthy Kids Member Grievance Form (Tagalog	Health Plan
Medi-Cal/Healthy Kids Member Grievance Form (Ting Vit	Health Plan
Medi-Cal Preventable Conditions Reporting Form	Health Plan
Medical Records Review Survey	Health Plan
Mills Act Survey	Assessor
New Business Questionnaire	Assessor
New Business Questionnaire	Assessor
Non-Professional Supervised Visitation Provider Declaration of Qualifications	Superior Court
Notice of Grievance Procedure of Clients	Behavioral Health