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All consumer posters and brochures for Medi-Cal clinic sites are downloadable at the following page - click here. Please contact QMS AOA at AQISSupportTeams@ochca.com or call (714) 834-5601 for any questions. Patient's rights posters and brochures are in downloadable format at the |
Clinical Information
- BH Provider Handbook Coding Manual Version 11
(Effective November 2020) - Clinician Coding Guide (Non-MD) (Effective 4/4/18)
- Clinician Coding Guide (MD) (Effective 4/4/18)
- Revised Encounter Document FAQ (1-7-14)
- Legal Classes and Court Conservator Status
- Service Strategies
- CANS & PSC-35 FAQ(6/25/2020)
- Integrated Practice CANS Form in English (4/1/2022)
- CANS IRIS Entry Quick Guide (Contracts)
- CANS Training Website Sign-Up Guide (01/31/2024)
- CANS Recertification Guide (01/31/2024)
| Title | Arabic | Chinese | English | Farsi | Korean | Spanish | Vietnamese |
| Pediatric Symptom Checklist (County Version) |  | | | | | | |
| Pediatric Symptom Checklist (Contract Version) |  | | | | | | |
PSC-35 IRIS Entry Quick Guide (Contracts) | | ||||||
PSC 35 Interpretation | |
Clinical Supervision
Click here for up-to-date information on Clinical Supervision Reporting Forms
Change of Provider/Second Opinion Log
Click here for up-to-date information on Change of Provider and Second Opinion Logs
Continuity of Care
Forms
Policy and Procedure
Training
Medication Consents [F346-7921] - 2019
Psychiatrist Information/Downloads
Medi-Cal Information
- BHS Medi-Cal Provider Information Page
- Medi-Cal Mental Health Plan - Provider Directory
- Provider Directory - Quick Guide [For Providers]
- Provider Directory - Translation Features
HIPAA - Notice of Privacy Practices
- Link to Notice of Privacy Practices (County Operated Provider Use Only)
Authorization to Use or Disclose Protected Health Information (PHI)
Please Clink links below to access the most up-to-date Authorization to Use or Disclose (ATD) PHI forms
- For Patient/Client use for Medical Records Request from Custodian of Records
- Revocation of Authorization to Use or Disclose Public Health Information
- For Clinic Use - County Intranet
Click on the icons in the tables below to download the appropriate file.
| Description | Arabic | Chinese | English | Farsi | Korean | Spanish | Vietnamese | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Advance Health Care Directives (F346-705) |  |  | | | | | |||||||
| Mental Health Plan Intake/ Advisement Checklist (F346-753) (October 2017) | | | | | | | |||||||
| Medi-Cal Handbook (2019) |   | | | | | | |||||||
| Audio Version |  | | | | | | |||||||
Grievance Forms, Posters, Fact Sheets and Tracking Forms
Forms - FOR COUNTY OPERATED PROVIDER USE ONLY
Car Seat Safety Flyers (County Use Only)
| Description | Chinese | English | Korean | Spanish | Vietnamese |
| National Voter Registration Act (NVRA) Preference Forms National Voter Registration FAQs (County Operated Provider Use Only) | | | | | |
Notice of Privacy Practices (NPP)
This is the County NPP given to patients/clients at the first delivery of medical treatment services. The NPP is also mailed to patients/clients provided medical benefits under an HCA supported health plan such as CCS, MSN, or CTU. Form #F042-01.1996 (County Operated Provider Use Only)
Notice of Privacy Practices Acknowledgement
This form helps the Orange County Health Care agency demonstrate that we have given our Notice of Privacy Practices (NPP) to each patient at the first point of service. This form is used to obtain client/patients signed acknowledgement of receipt. (County Operated Provider Use Only)