形式：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 – 員工和醫療保健從業人員 (HCP) 訊息
- DHCS 5054 – Notice of Inspection of Confidential Records
- DHCS 5077 – Health Screening Report
- DHCS 5078 – Centrally Stored Medication and Destruction Record
- DHCS 5079 – 事故、傷害或死亡報告
- DHCS 5080 – Personal Rights – Alcohol Recovery and Drug Treatment Facilities
- DHCS 5080 SP – Derechos Personales – Facilidades de Recuperación y Tratamiento
- DHCS 5082 – Program主管訊息
- DHCS 5083 – 行政組織 – 公司、非營利公司、有限責任公司、普通合夥或有限合夥企業
- DHCS 5084 – 行政組織 – 公共機構或自營商
- DHCS 5085 – 行政責任
- DHCS 5086 – 復健與治療服務時間表
- 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 – 顧客健康問捲和初步篩檢問題
- DHCS 5103 SP – Cuestionario de Salud y Preguntas Iniciales de Evaluación del Cliente
- DHCS 5104 – Outpatient Fire Clearance
- DHCS 5111 – 自營商申請表
- DHCS 5115 – 分區審批
- DHCS 5140 – 向DHCS揭露
- DHCS 5255 – Supplemental Application Request for Additional Services
- DHCS 5256 – Health Care Practitioner Incidental Medical Services Acknowledgement
- DHCS 5999 – Request for License/Certification Extension