Forms

Mental Health Services

Patient' Rights and Responsibilities July 2022
Patients' Rights and Responsibilities July 2022 (Large Font)
Manual de Beneficiarios Julio 2022
Manual de Beneficiarios Julio 2022 (Letra Grande)
Provider Directory (August 2025)
Provider Directory (Large Font August 2025)
Directorio de Proveedores (Agosto 2025)
Directorio de Proveedores (Letra Grande Agosto 2025)

Mental Health Services and Substance Use Disorder Services

Substance Use Disorder Services

Mental Health Services Act Annual Update

Beneficiary Information

Non-Discrimination Statement
Declaracion de no Discriminacion
Notices of Privacy Practices
Notice of Privacy Practices (Large Font)
Notificacion de Practicas Privadas
Notificacion de Practicas Privadas (Letra Grande)
Language Assistance
Community Resources List
Grievance Form
Formulario Para Denuncia
Standard Appeal Form
Formulario Para Apelacion Estandar
Expedited Appeal Form
Formulario Para Apelacion Urgente
Patients' Rights and Responsibilities
Patients' Rights and Responsibilities (Large Font)
Derechos y Responsabilidades del Paciente
Derechos y Responsabilidades del Paciente (Letra Grande)

Other

Client Consents

Consent for Email Communication (Spanish)

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