Substance Use Disorder Services – Forms

Licensing and Certification Section (LCS)

• Forms

Narcotic Treatment Program

• Consent For The Release of Confidential Information (DHCS 5024)

Drug Medi-Cal Treatment Program (DMC)

• Forms

CalOMS

• DHCS 5261 Form – CalOMS Approver Form (PDF)

DATAR

• DHCS 3300 – DATAR County Approver Form (PDF)