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Mental Health Information & Forms - Consumers

The official Mendocino County website has a new home! Please visit:
MendocinoCounty.org

The content here is no longer updated and will soon redirect to the new site.

24/7 Toll Free Crisis Line:
1-855-838-0404

Mendocino County Access Line: 1-800-555-5906

Linea de Crisis Llamada Gratis 24/7:
1-855-838-0404

Consumer Resources Brochures
Ukiah Area Resources English Spanish
Fort Bragg and Coastal Resources English Spanish
Willits and North County Resources English Spanish
Forms
English Spanish
Early & Periodic Screening, Diagnosis & Treatment for Children and Young Adults Detección, Diagnóistico y Tratamiento Oportunos y Periódicos para Niños y Adultos Jóvenes
Grievance and Appeals Request Form listen Petición de Apelación y Quejas escuchar
Grievance and Appeals Process Brochure Quejas y Apelaciones Folleto Proceso
Guide to Medi-Cal Mental Health Services (Standard Print)
Guía Para Servicios de Salud Mental de Medi-Cal
Mental Health Plan Member Services Brochure Plan de Salud Mental Servicios para Miembros Folleto
Mental Health Plan Comprehensive Program Guide Plan de Salud Mental Integral Guía del Programa
MHP Provider List PSM Lista de Proveedores
Patients' Rights Advocate Defensor de los Derechos del Paciente
Request for a Change of Provider Petición para Cambio de Proveedor
Request for a Second Opinion Petición por una Segunda Opinion
Improving the Quality of Care Mejorar la Calidad de Atención
Your Right to Make Decisions About Your Medical Treatment Su Derecho de Hacer las Decisiones Acerca del Tratamiento Médico
Medi-Cal Notice of Privacy Booklet Aviso de Privacidad de Medi-Cal
Receipt of Notice of Privacy Practices Recibo del Aviso de Prácticas de Privacidad
Large Type / Letra Grande
Guide to Medi-Cal Mental Health Services - Large Type Edition
Guía Para Servidios de Salud Mental de Medi-Cal - Edición Letra Grande
Mental Health Plan Member Services Brochure - Large Type Edition
Plan de Salud Mental Servicios para Miembros Folleto - Edición Letra Grande
Medi-Cal Notice of Privacy - Large Type Edition
Patients' Rights Advocacy Brochure: English Spanish
Request for a Change of Provider: English Spanish
Grievance and Appeals Process Brochure: English Spanish
Your Right to Make Decisions About Medical Treatment: English Spanish
Request for a Second Opinion: English Spanish

© Copyright 1997-2017, The County of Mendocino
501 Low Gap Road, Ukiah, CA 95482