Forms: DHCS 5000
- DHCS 5018 – Order Form
- DHCS 5021 – User Authorization
- DHCS 5023 – Media Loan Request
- DHCS 5024 – Consent for the Release of Confidential Information
- DHCS 5050 – Cov Ntaub Ntawv Txog Cov Neeg Ua Haujlwm thiab Cov Kws Kho Mob (HCP)
- DHCS 5054 – Notice of Inspection of Confidential Records
- DHCS 5077 – Health Screening Report
- DHCS 5078 – Centrally Stored Medication and Destruction Record
- DHCS 5079 – Daim Ntawv Qhia Txog Qhov Xwm Txheej, Kev Raug Mob lossis Kev Tuag
- DHCS 5080 – Personal Rights – Alcohol Recovery and Drug Treatment Facilities
- DHCS 5080 SP – Derechos Personales – Facilidades de Recuperación y Tratamiento
- DHCS 5082 – Cov Ntaub Ntawv Txog Tus Thawj Coj ntawm Qhov Kev Pab Cuam
- DHCS 5083 – Lub Koom Haum Tswjfwm – Lub Tuam Txhab, Lub Koom Haum Tsis Muaj Peev Xwm Ua Lag Luam Lub Tuam Txhab Muaj Lub Luag Haujlwm Txwv, Kev Koom Tes Dav Dav lossis Kev Koom Tes Txwv
- DHCS 5084 – Lub Koom Haum Tswjfwm – Lub Chaw Haujlwm Pej Xeem lossis Tus Tswv Ib Leeg
- DHCS 5085 – Lub Luag Haujlwm Saib Xyuas Kev Tswjfwm
- DHCS 5086 – Teem Caij Cov Kev Pabcuam Rov Zoo thiab Kev Kho Mob
- DHCS 5099 – CalOMS – ADP 100177 CalOMS ITWS County-Direct Provider Approver
- DHCS 5100 – CalOMS – ADP 100178 CalOMS ITWS Vendor Approver
- DHCS 5101 – CalOMS – ADP 100179 CalOMS ITWS Internal Employee Approver
- DHCS 5102 – CalOMS – ADP 100180 CalOMS ITWS User Cancellation
- DHCS 5103 – Daim Ntawv Nug Txog Kev Noj Qab Haus Huv ntawm Cov Neeg Siv Khoom thiab Cov Lus Nug Txog Kev Tshuaj Xyuas Thawj Zaug
- DHCS 5103 SP – Cuestionario de Salud y Preguntas Iniciales de Evaluación del Cliente
- DHCS 5104 – Outpatient Fire Clearance
- DHCS 5111 – Daim Ntawv Thov Ua Tus Tswv Ib Leeg
- DHCS 5115 - Kev Pom Zoo Txog Cheeb Tsam
- DHCS 5140 - Kev Tshaj Tawm rau DHCS
- DHCS 5255 – Supplemental Application Request for Additional Services
- DHCS 5256 – Health Care Practitioner Incidental Medical Services Acknowledgement
- DHCS 5999 – Request for License/Certification Extension