About
Enrollment
Locations and Service Area
Agency Owners
Policies and Notices
FAQs
Leadership
Careers
Service Announcements
News
Resources
COVID-19 Resources
For Providers
Newsletter Archive
Webinars
Getting Involved
Contact
About
Enrollment
Locations and Service Area
Agency Owners
Policies and Notices
FAQs
Leadership
Careers
Service Announcements
News
Resources
COVID-19 Resources
For Providers
Newsletter Archive
Webinars
Getting Involved
Contact
SPANISH LANGUAGE FORM VERSIONS
:
Intake Cover Letter - Spanish
West Region Referral Form - Spanish
HIPAA Notice of Privacy Practices - Spanish
Acknowledgement of Notices and Privacy Practices - Spanish
Authorization for Release of PHI - Spanish
Blank Authorization for Release of PHI (For Additional Providers) - Spanish