The DHCS Licensing and Certification Portal now accepts renewals for DUI program quarterly report submissions. DHCS encourages licensed and prospective DUI programs to set up their organization and verify their profile on the DHCS Licensing and Certification Portal before submitting applications. 

Applications

Initial Application Forms

• Application for Licensure– DHCS 7785
• Designation of Administrative Responsibility– DHCS 7795
• Staff Information– DHCS 7805
• Statement of Compliance– DHCS 7810
• Administrator/Director Information– DHCS 7800
• Financial Statement– DHCS 7815

Quarterly Licensing and Participant Enrollment Reports

• 12 Hour Education Enrollment Report
• 3-Month DUI Program Enrollment Report
• 6-Month DUI Program Enrollment Report
• 9-Month DUI Program Enrollment Report
• 18-Month DUI Program Enrollment Report
• 30-Month DUI Program Enrollment Report

Resources

• Probationary Status, Temporary Suspension Order and Revoked – Program List