Note: For all HIPAA related forms and questions, please visit the LA-DMH HIPAA Site.

• Data Center Registration
  (County | Non-County)
• Confidentiality Oath (PDF)
• Board Correspondence
• Notice of Privacy Practices
  English | Spanish
• DMH Advance Health care directive acknowledgement form
• Annual Assessment update
• Client Care/Coordination Plan form
• 5150 Designation Application (PDF)
• 5150/5585 Data Collection Form (PDF)
• Initial Treatment Authorization Request (PDF)
• Continued Treatment Authorization Request (PDF)
• State Outcome Survey November 2006 (Chinese/Adult)
• State Outcome Survey November 2006 (Chinese/Older Adult)
• State Outcome Survey November 2006 (Chinese/Family)
• State Outcome Survey November 2006 (Chinese/Youth)
• State Outcome Survey November 2006 (English/Adult)
• State Outcome Survey November 2006 (English/Older Adult)
• State Outcome Survey November 2006 (English/Family)
• State Outcome Survey November 2006 (English/Youth)
• State Outcome Survey November 2006 (Korean/Adult)
• State Outcome Survey November 2006 (Korean/Older Adult)
• State Outcome Survey November 2006 (Korean/Family)
• State Outcome Survey November 2006 (Korean/Youth)

• State Outcome Survey November 2006
  (Russian/Adult)
• State Outcome Survey November 2006
  (Russian/Older Adult)
• State Outcome Survey November 2006
  (Russian/Family)
• State Outcome Survey November 2006
  (Russian/Youth)
• State Outcome Survey November 2006 (Spanish/Adult)
• State Outcome Survey November 2006 (Spanish/Older Adult)
• State Outcome Survey November 2006 (Spanish/Family)
• State Outcome Survey November 2006 (Spanish/Youth)
• State Outcome Survey November 2006 (Tagalog/Adult)
• State Outcome Survey November 2006 (Tagalog/Older Adult)
• State Outcome Survey November 2006 (Tagalog/Family)
• State Outcome Survey November 2006 (Tagalog/Youth)
• State Outcome Survey November 2006
  (Vietnamese/Adult)
• State Outcome Survey November 2006
  (Vietnamese/Older Adult)
• State Outcome Survey November 2006
  (Vietnamese/Family)
• State Outcome Survey November 2006
  (Vietnamese/Youth)

DMH Policy and Procedures

Suicide Prevention and Survivor Hotline
1-877-727-4747 inside LA County
1-310-391-1253 outside LA County

Alzheimer's Association Helpline
1-800-660-1993

California Youth Crisis Hotline
1-800-843-5200

Child Abuse Hotline
1-800-540-4000

Domestic Violence - Sexual Assault Hotline
1-800-339-3940

Elder Abuse Hotline
1-800-992-1660

National HIV/AIDS Hotline
1-800-342-2437

Substance Abuse Hotline
1-800-564-6600 (9-5 Monday - Friday)