Forms Library

Welcome to the Forms Library. Contained below are links to most forms used by CenCal Health. Some forms may require providers to log in to the restricted section of the website to access. If you’re unable to find what you were looking for, please contact Provider Services at (805) 562-1676 or via email.


Behavioral Health

Holman Referral Form

To learn more about Behavioral Health click here


Pharmacy Forms and downloads


RBM Fact Sheet Quick Reference Guide 

To learn more about Radiology click here



For claims forms click here

Health Education

For health materials click here


Cultural & Linguistic

For more information click here


Fraud and Abuse Reporting for more info click here
Fraud by a Provider
Fraud by a Member (English) 
Fraud by a Member (Spanish)

Care Management

Referral Form

Preventive Healthcare
For information please click here to view the provider manual

Education and Training Materials click here

Behavioral Health and PCP Care Coordination Forms
CenCal Care Coordination BH request from PCP
CenCal Care Coordination PCP request from BH