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Approver Certification Forms

Behavioral Health Information Systems

​​​Mental Health Client and Services Information (MHCSI)​​

This form is for use by the county Behavioral Health Director to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the DHCS Mental Health Client and Services Information (MHCSI).​

Download MHCSI (DHCS 5259)​

Substance Use Disorders Cost Reporting System (SUDCRS)​​

This form is for use by the county Alcohol and Drug program (AOD) Administrator to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the DHCS Substance Use Disorders Cost Reporting System (SUDCRS).​

Download SUDCRS (DHCS 5260)

Mental Health Data ​​Collection and Reporting (MHSA-DCR)

This form is for use by the county Behavioral Health Director to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the ​DHCS Mental Health Data Collection and Reporting (MHSA-DCR)​

Download MHSA-DCR (DHCS 5262)​

Functional Assess​ment Screening Tool (FAST)​

​​This form is for use by the county Behavioral Health Director to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the DHCS Mental Health Functional Assessment Screening Tool (FAST)

Download FAST (DHCS 5268​)

Provider Inf​ormation Management System (PIMS)​

This form is for use by the county Behavioral Health Director to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the DHCS Mental Health Provider Information Management System (PIMS)​​

 

​California Outcomes Measurement Syst​​em (CalOMS)

​This form is for use by the county Alcohol and Drug program (AOD) Administrator to designate two contacts to be responsible for managing the county and vendor staff (if applicable) access to the DHCS California Outcomes Measurement System (CalOMS).​​

Download CalOMS (DHCS ​​5261)​​


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Last modified date: 12/4/2025 11:31 AM