| Contract agencies can obtain pamphlets, forms and posters by contacting CYS QRT at cysqrt@ochca.com or calling 714-796-0123. |
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Clinical Information
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 BHS Formulary |
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| BHS-Coding Manual |
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Client Intake Questionnaire  |
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| CYS Medication Consents |
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| CYS Prescribing Practices |
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| EPSDT Documentation Manual |
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 Included-Excluded-Diagnoses |
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| JV-220A-prescribing-physician-statement.pdf JV-220A (form fillable) |
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| Legal Classes and Court Conservator Status |
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| Service_Strategies.pdf |
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| Treatment Authorization Request (TAR) |
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Medi-Cal Information (For Distribution to Consumers )
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| Behavioral Health Services Directory |
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| Mental Health Provider List |
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English
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| Farsi |
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| Spanish |
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| Vietnamese |
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Mental Health Plan Intake/Advisement Checklist
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 English
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Farsi
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Spanish
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Vietnamese
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Guide to Mental Health Services
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| English |
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| Farsi |
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| Spanish |
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| Vietnamese |
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| Audio Version (English,Farsi, Spanish, Vietnamese) |
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| Advanced Health Care Directives |
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| English |
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| Farsi |
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| Spanish |
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| Vietnamese |
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| Grievance Appeal Form |
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| English |
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| Farsi |
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| Spanish |
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| Vietnamese |
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Notice of Action-A
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| Notice of Action Policy and Procedures (Includes NOA-A English version) |
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Spanish NOA-A
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Vietnamese NOA-A
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| HIPAA |
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| Authorization to Use and Disclose Protected Health Information |
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Authorization to Use and Disclose Protected Health Information (Spanish version)
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Revocation of Authorization to Use or Disclose Public Health Information (form fillable)
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| Revocation of Authorization to Use or Disclose Public Health Information (Instructions) |
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HIPAA Acknowledgment of receipt (Access only through employee Intranet)
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| English/Vietnamese |
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| Farsi |
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| Spanish |
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| Notice or Privacy Practices - NPP |
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| English |
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| Farsi |
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| Spanish |
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| Vietnamese |
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HIPAA Downloads (Authorization to use and disclose protected health information and related documents)*
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CYS QRT Homepage