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​PASRR Enrollment

Back to PASRR


Early enrollment is advised to avoid delays and possible denials of reimbursement. Effective June 30, 2015, DHCS Mental Health Services Division, PASRR Section will not accept faxed or mailed DHCS 6170 forms. Faxed or mailed forms will be returned to the submitting facility with direction to enroll and enter them using the online system.
Please e-mail questions about the PASRR process and the new online system to: Or call the DHCS IT Service Desk at (916) 440-7000.
The PASRR online system replaces the existing paper based PASRR Level I screening form DHCS 6170 with a comprehensive electronic version. The new PASRR Online system is a much more efficient means of submitting the Screening Form and expedites DHCS issuing Determination Letters. Facilities will need internet access using a desktop, laptop, or tablet PC device. The new Online PASRR system is compatible with supported browser types and internet providers.

How To Enroll In The Online System

To enroll staff in the new online process, please complete the Administrator/User request and e-mail it to
Carefully follow these instructions when completing the Administrator/User request form: 
  1. Be sure the names (both first and last) and e-mails are entered correctly.
  2. The e-mail request must come from the e-mail account of the Requestor. The request must be sent as an attachment with the subject: Name of your facility – REQUEST FOR PASRR ADMIN/USER ACCOUNTS.
  3. The request must be e-mailed to
  4. Please note that if your facility has more than one physical address, a separate form must be completed for Administrators and Users at each separate location.
Once Nursing Facilities (NF) and General Acute Care Hospitals (GACH) complete the first step in the enrollment process; each Administrator and User will receive an encrypted e-mail from DHCS that includes a temporary password. This password expires in 4 days. Each person will use the temporary password to create a NEW password in order to log on to Online PASRR. You will need the NEW password the first time you log onto Online PASRR.
If you encounter problems enrolling and using the new PASRR online system contact the DHCS IT Service Desk at (916) 440-7000.
Last modified on: 1/7/2016 9:04 AM