Back to Level of Care Designation

• DHCS Level of Care Designation Application (DHCS 4022)
• New Provider Level of Care Attestation Statement (DHCS 4030)
• Current Provider Level of Care Attestation Statement (DHCS 4031)
• Staff and Health Care Practitioner (HCP) Information (DHCS 5050)
  
• Schedule of Recovery and Treatment Services (DHCS 5086)