Select a language:

AQIS - CYPBH BHS Downloads

All consumer posters and brochures for Medi-Cal clinic sites are downloadable from this page. 

Please contact AQIS CYPBH at AQISSupportTeams@ochca.com or call (714) 796-0123 for any questions.

Patient's rights posters and brochures are in downloadable format at the
 Patients' Rights Advocacy Services website

Please contact Patients Rights Advocacy Services at (714) 834-5647 for any additional questions.

Clinical Information

    Caregiver Intake Questionnaires  new 8/7/19 

    Clinical Resources

     Clinical Supervision

 

Change of Provider/Second Opinion Log - NEW  

 Medication Consents [F346-7921] - 2019

    Outcome Measure Workflows updated01/13/2020

    Pediatric Symptom Checklist 

    Psychiatrist Information/Downloads

Continuity of Care  

Medi-Cal Information

 

Advance Health Care Directives (F346-705)

Authorization to Use or Disclose Protected Health Information (PHI) 

Please click links below to access the most up-to-date Authorization to Use or Disclose (ATD) PHI forms

    EPSDT-TBS Brochures (MC-003-DHCS)

 

Grievance Forms, Posters, Fact Sheets and Tracking Forms

    HIPAA - Notice of Privacy Practices

 

Medi-Cal Handbook

    Mental Health Plan Intake/Advisement Checklist (F346-753) (October 2017)

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) 


PDF version of Notice of Privacy Practices Employee Benefits 

PDF version of Notice of Privacy Practices Employee Benefits

PDF version of Notice of Privacy Practices Employee Benefits 

Spanish PDF version of Notice of Privacy Practices Employee Benefits

Vietnamese PDF version of Notice of Privacy Practices Employee Benefits

Read about downloading files.