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.
Authorizations Behavioral Health Holman Referral Form To learn more about Behavioral Health click here Pharmacy Pharmacy Forms and downloads Radiology RBM Fact Sheet Quick Reference Guide To learn more about Radiology click here Contracting/Credentialing California Participating Physician Application (CPPA) Addendum B Form Provider Information Form W-9 Taxpayer Information For more information about joining our network click here Claims For claims forms click here Health Education For health materials click here Member Member Rights and Responsibilities - English Member Rights and Responsibilities - Spanish Member Grievance Form SBHI & SLOHI - English Member Grievance Form SBHI & SLOHI - Spanish Member Grievance Form HF,HK,PP2,IHSS - English Member Grievance Form HF,HK,PP2,IHSS - Spanish Resources for disabled and Special Needs Community Resources California Minor Consent Laws Cultural & Linguistic For more information click here Other 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