Office of Family Planning Forms
- DHCS 4001 Retroactive Eligibility Certification (REC)
- DHCS 4001SP Retroactive Eligibility Certification (REC-Spanish)
- DHCS 4461 Client Eligibility Certification (CEC)
- DHCS 4461SP Client Eligibility Certification (CEC-Spanish)
- DHCS 4469 Family PACT Provider Agreement (rev.10-25)
- DHCS 4475 Site Certifier for Multiple Locations Declaration (rev. 01-26)
- DHCS 4470 Family PACT Practitioner Participation Agreement
- DHCS 8649 Consent for Sterilization
- DHCS 8649 Consent for Sterilization (Esp)
- DHCS 8649 Additional Languages Alt: Arabic, Armenian, Farsi, Hindi, Hmong, Japanese, Kher, Korean, Lao, Mien, Punjabi, Russian, Tagalog, Thai, Traditional Chinese, Ukrainian, Vietnamese
