Medi-Cal Informing Materials
MHS 112-3 NOABD Delivery System Notice
English (PDF: 859 kB)
MHS 112-4 NOABD Modification Notice
English (PDF: 886 kB)
MHS 112-8 NOABD Financial Liability Notice
English (PDF: 834 kB)
MHS 168 Beneficiary Request for Service Authorization
English (PDF: 260 kB)
These documents are given to clients receiving specialty mental health services that are covered by Medi-Cal.
Consumer Notification of Licensing Boards
Free Language Assistance Services
Point to Your Language Poster
Attention contractors: You are required by law to provide clients with your own HIPAA Notice of Privacy Practices statement.
Attention clients: these are the County Mental Health Services Notice of Privacy Practices statements.
Notice of Privacy Practices for Health Care Clients
Print version: English | Spanish (PDF: 193 and 122 kB)