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 (July 2025)
- Provider Directory (Large Font July 2025)
- Directorio de Proveedores (Julio 2025)
- Directorio de Proveedores (Letra Grande Julio 2025)
Mental Health Services and Substance Use Disorder Services
- Integrated MHP and ODS Member Handbook
- Intergrated MHP and ODS Member Handbook - Large Font
- Manual de Miembros de MHP y ODS Integrados
- Manuel de Miembros de MHP y ODS Integrados - Letra Grande
Substance Use Disorder Services
Mental Health Services Act Annual Update
- MHSA Annual Update FY 24-25
- MHSA Annual Update FY 21-22
- MHSA Annual Update FY 19-20
- MHSA Annual Update FY 19-20 - Notice of Review Period Public Hearing
- MHSA Annual Update FY 19-20 - Notice of Review Period Public Hearing (Spanish)
- MHSA Plan Public Comment Form - FY 19-20 Annual Update (English/Spanish) - PDF
- MHSA Plan Public Comment Form - FY 19-20 Annual Update (English/Spanish - Word
- MHSA Revenue and Expenditure Report (MHSA RER) - FY 18-19
- Adjustment Worksheet County Certification - FY 18-19
Beneficiary Information
- Non-Discrimination Statement
- Declaracion de no Discriminacion
- Notice of Privacy Practices
- Notice of Privacy Practices (Large Font)
- Notificacion de Practicas de Privacidad
- Notificacion de Practicas de Privacidad (Letra Grande)
- Advance Directives
- Advance Directives (Large Font)
- Directivas Anticipadas
- Directivas Anticipadas (Letra Grande)
- Notice of Availability Taglines
- 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
Substance Use Disorder Services
Mental Health Services Act Annual Update
- MHSA Annual Update FY 24-25
- MHSA Annual Update FY 21-22
- MHSA Annual Update FY 19-20
- MHSA Annual Update FY 19-20 - Notice of Review Period Public Hearing
- MHSA Annual Update FY 19-20 - Notice of Review Period Public Hearing (Spanish)
- MHSA Plan Public Comment Form - FY 19-20 Annual Update (English/Spanish) - PDF
- MHSA Plan Public Comment Form - FY 19-20 Annual Update (English/Spanish - Word
- MHSA Revenue and Expenditure Report (MHSA RER) - FY 18-19
- Adjustment Worksheet County Certification - FY 18-19
Beneficiary Information
- Non-Discrimination Statement
- Declaracion de no Discriminacion
- Notice of Privacy Practices
- Notice of Privacy Practices (Large Font)
- Notificacion de Practicas de Privacidad
- Notificacion de Practicas de Privacidad (Letra Grande)
- Advance Directives
- Advance Directives (Large Font)
- Directivas Anticipadas
- Directivas Anticipadas (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