All consumer posters and brochures for Medi-Cal clinic sites are downloadable from this page. Patient's rights posters and brochures are in downloadable format at the |
Clinical Information
Caregiver Intake Questionnaires 
8/7/19
- Caregiver Intake Questionnaire_ARABIC
- Caregiver Intake Questionnaire_ENGLISH
- Caregiver Intake Questionnaire_FARSI
- Caregiver Intake Questionnaire_KOREAN
- Caregiver Intake Questionnaire_SPANISH
- Caregiver Intake Questionnaire_VIETNAMESE
Clinical Resources
- BH Provider Handbook Coding Manual Version 11
(Effective November 2020) - Clinician Coding Guide (Non-MD) Effective 4/4/18
- Clinician Coding Guide (MD) Effective 4/4/18
- CYPBH Annual Provider Training - Forms/Resources/Notes(County Version) Effective 12/2017
- CYPBH Annual Provider Training-Forms/Resources/Notes(Contract Version) Effective 12/2017
- DHCS Therapeutic Behavioral Health Services (TBS) Documentation Manual Effective 10/1/2009
- EPSDT Documentation Manual
- Legal Classes and Court Conservator Status
- Medi-Cal Manual for Intensive Care Coordination (ICC) Effective 1/1/18
- New Provider Training-Forms/Resources/Notes (County Version)
- New Provider Training-Forms/Resources/Notes (Contract Version)
- Revised Encounter Document FAQ 1-7-14
- Service Strategies
Clinical Supervision
Click here for up-to-date information on Clinical Supervision Reporting Forms
Change of Provider/Second Opinion Log
Click here for up-to-date information on Change of Provider and Second Opinion Logs
Medication Consents [F346-7921] - 2019
Outcome Measure Workflows 01/13/2020
Pediatric Symptom Checklist
Psychiatrist Information/Downloads
- BHS Formulary
- CYS Prescribing Practices
- Guide to Psychotropic Medication Forms-JV-217-Info-Judicial Council (Effective 1/1/2018)
- JV-220 Application Regarding Psychotropic Medication (Typically completed by SSA Staff or Probation Staff) (Effective 1/1/2018)
- JV-220 (A) Prescribing Physician Statement-Attachment (1/1/2018)
- JV 220 (B) Physician's Request to Continue Medication—Attachment (Effective 1/1/2018)
- Treatment Authorization Request (TAR)
Continuity of Care
Forms
Policy and Procedure
Training
Medi-Cal Information
- BHS Medi-Cal Provider Information Page
- Medi-Cal Mental Health Plan - Provider Directory
- Provider Directory - Quick Guide [For Providers]
- Provider Directory - Translation Features
Advance Health Care Directives (F346-705)
Authorization to Use or Disclose Protected Health Information (PHI)
Please click links below to access the most up-to-date Authorization to Use or Disclose (ATD) PHI forms
EPSDT-TBS Brochures (MC-003-DHCS)
Grievance Forms, Posters, Fact Sheets and Tracking Forms
HIPAA - Notice of Privacy Practices
- Link to Notice of Privacy Practices (County Operated Provider Use Only)
Medi-Cal Member Handbooks
Mental Health Plan Intake/Advisement Checklist (F346-753) (October 2017)
Forms - FOR COUNTY OPERATED PROVIDER USE ONLY
Car Seat Safety Flyers (County Use Only)
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