Health Services

Contra Costa County, CA

Official Website: http://cchealth.org

Mission is to care for and improve the health of all people in Contra Costa County with special attention to those who are most vulnerable to health problems.

Forms & Documents

Browse all Health Services government forms

81 - 100 of 154 forms

Form Title Topics
MHA002 - Change of Therapist/Doctor or Change of Diagnosis Form
MHA005 - Client Acknowl of BH Attendance Guidelines Adult
MHA006 - Client Acknowl of BH Attendance Guidelines Child Adol
MHA-013 - ShareCare and Report Folder Access Request Form
MHA-021 - Unusual Occurrence Notification
MHA-031 - MRN/Demographic Update Request
MHA036 - Request for Eligibility Verification
MHA066 - Void & Replace Request
MHA094 - CCMHP Insurance-Medicare Verification Notification Form
MHA095 - CCMHP Insurance-Medicare Payment Notification Form
MHA098 - Appeal Submission Checklist
MHC305 - ICC Referral
Minimum Quality Drug Treatment Standards for DMC - Document 2F(a
Modification Notice
MRN/Demographic Update Request
NAR Adverse Benefit Determination Overturned Notice
NAR Adverse Benefit Determination Upheld Notice
NAR Your Rights Attachment
National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care
New Drug Medi-Cal Regulations

Contact Information & Office Locations

1 contact point

Contra Costa Health Services

Address:
1220 Morello Ave
Suite 200
Martinez, CA 94553

Phone numbers:
  • (925) 313-6740 (Public Health)
  • (925) 646-2441

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