Screening/Triage

Notice of Certification for 14 day Intensive Treatment – 5250 or Additional 30 Day Intensive Treatment 5270 for Grave Disability – MH 767

Application for Assessment & Evaluation for 5150 – MH 766

Service Request Log – MH 718

Mental Health Triage – MH 679

Adult Screening Tool – DHCS 8765A

Youth Screening Tool – DHCS 8765C

Translated Screening Tools