Privacy Forms

The following privacy forms help individuals access their protected health information and exercise other privacy rights.  These are the Health Information Portablity and accountability Act (HIPAA) forms used by DHCS health plans covered by HIPAA.

General Forms

Medi-Cal Forms

California Children's Services

Genetically Handicapped Persons' Program


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Links on this page are documents in Adobe Acrobat Portable Document Format (PDF).

Last modified date: 6/24/2019 2:03 PM