Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Cov Ntawv Thov, Cov Ntawv, thiab Cov Nqi​​ 

Daim ntawv thov, Daim ntawv, thiab cov nqi​​ 

Cov Hom Ntawv Thov Tshiab Ntxiv rau Lub Rooj vag Kev Tso Cai thiab Daim Ntawv Pov Thawj Kev Noj Qab Haus Huv​​ 

Lub Rooj Sab Laj Txog Kev Tso Cai thiab Daim Ntawv Pov Thawj Kev Noj Qab Haus Huv Tus Cwj Pwm tam sim no yuav lees txais cov ntawv thov hloov kho, ua rau tag nrho plaub hom ntawv thov kev tso cai thiab daim ntawv pov thawj rau kev siv tshuaj yeeb dej cawv (SUD) uas DHCS tswj hwm muaj nyob hauv online. Cov neeg muab kev pabcuam haus dej cawv thiab lwm yam tshuaj yeeb tam sim no tuaj yeem xa daim ntawv thov thawj zaug, qib kev saib xyuas, kev hloov kho, thiab daim ntawv thov txuas ntxiv rau cov kev pabcuam uas tau tso cai thiab/lossis tau ntawv pov thawj. Cov neeg muab kev pab cuam uas tseem ua haujlwm raug txhawb kom nkag mus rau hauv los teeb tsa lawv lub koom haum thiab txheeb xyuas lawv cov ntaub ntawv.​​ 

Nkag mus​​ 

Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) muaj txoj cai nkaus xwb los tso cai rau cov neeg laus haus cawv lossis tshuaj yeeb tshuaj rov qab los yog chaw kho mob, tseem hu ua cov chaw kho mob hauv tsev (SUD). DHCS tseem muaj txoj cai tswj xyuas thiab saib xyuas tag nrho cov neeg mob haus cawv thiab lwm yam kev pab cuam tshuaj, tseem hu ua SUD kev kho mob sab nraud uas muaj kev kho mob, rov qab los, detoxification, lossis Kev Kho Mob rau Kev Kho Mob (MAT). Txhua qhov kev pabcuam SUD ua haujlwm nyob rau hauv qhov chaw uas raug zam los ntawm DHCS yuav tsum tau ntawv pov thawj raws li Txoj Cai Kev Noj Qab Haus Huv thiab Kev Nyab Xeeb, subdivision (b) ntawm Tshooj 11832.3, thiab ua tau raws li cov kev cai uas tau teev tseg hauv Daim Ntawv Pov Thawj rau Cawv thiab Lwm Cov Kev Pabcuam (hloov Lub Ob Hlis 2025) tuaj yeem yeem thov rau daim ntawv pov thawj.​​   

Daim ntawv thov​​ 

Thov nco ntsoov: Yog tias koj xav thov daim ntawv tso cai thiab daim ntawv pov thawj, peb xav kom koj ua daim ntawv thov no los ntawm DHCS Licensing and Certification Portal. 

Yog tias koj tsis siv Licensing and Certification Portal, xa tag nrho cov ntawv thov ua ke los ntawm email rau LCDSUDApplication@dhcs.ca.gov. Rau thawj zaug muab daim ntawv tso cai thiab daim ntawv pov thawj, suav nrog daim ntawv DHCS 6002 thiab DHCS 6040. Rau cov ntawv thov rov ua dua tshiab, suav nrog daim ntawv DHCS 5999 thiab DHCS 6043. Txhua daim ntawv thov yuav tsum xa ua ib feem ntawm tib pob. Tsis tas yuav xa cov ntaub ntawv pov thawj ob daim.​​ 

DHCS Level of Care Designation​​ 

Thov nco ntsoov: Yog tias koj xav thov daim ntawv tso cai thiab daim ntawv pov thawj, koj tuaj yeem raug qhia kom ua tiav daim ntawv thov no hauv DHCS Licensing and Certification Portal.​​ 

Yog tias koj xaiv tsis siv Licensing and Certification Portal thiab xa los ntawm email, koj yuav tsum ua kom tiav thiab xa tag nrho cov ntawv ua ke. Rau cov ntawv thov thawj zaug, qhov no suav nrog DHCS 6002, DHCS 6040, DHCS 4022, thiab DHCS 4030, raws li siv tau.​​  

Txhua daim ntawv thov yuav tsum xa ua ib feem ntawm tib pob ntawv thov. Cov ntaub ntawv pov thawj uas theej ob daim tsis tas yuav xa tuaj.​​  

Kev xa cov ntawv thov thawj zaug thiab qib kev saib xyuas tib lub sijhawm pab ua kom muaj kev tshuaj xyuas raws sijhawm thiab sib koom tes ntawm koj daim ntawv tso cai thiab qib kev saib xyuas.​​ 

Cov Ntawv Ntxiv​​ 

Incidental Medical Services Certification Form – Health Care Practitioner Client Assessment (DHCS 4026)​​ 
Cov Neeg Ua Haujlwm thiab Tus Kws Kho Mob (HCP) Cov Ntaub Ntawv (DHCS 5050)​​ 
Daim Ntawv Qhia Txog Kev Kho Mob (DHCS 5077)​​ 
Cov Ntaub Ntawv Tus Thawj Coj Txoj Haujlwm (DHCS 5082)​​ 
Administrative Organization – Corporation, Nonprofit Corporation Limited Liability Company, General Partnership or Limited Partnership (DHCS 5083)​​ 
Administrative Organization – Public Agency or Sole Proprietor (DHCS 5084)​​ 
Lub luag haujlwm ntawm kev tswj hwm (DHCS 5085)​​ 
Teem sijhawm ntawm Kev Pabcuam Rov Qab thiab Kev Kho Mob (DHCS 5086)​​ 
Client Health Questionnaire thiab Initial Screening Questions (DHCS 5103)​​ 
Cuestionario de Salud y Preguntas Iniciales de Evaluación del Cliente (DHCS 5103 SP)​​ 
Cov Lus Nug Txog Cov Neeg Ua Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS 5105)​​ 
Kev Pabcuam Kev Noj Qab Haus Huv Kev Pabcuam Tsis Txaus Siab Kev lees paub (DHCS 5256)​​ 

Lwm yam Forms​​ 

Nqi​​