Form DHCS5102 (ADP100180) Caloms Itws County / Direct Provider / Vendor User Cancellation for Canceling User Access to the Caloms Treatment Data System - California

Form DHCS5102 (ADP100180) Caloms Itws County / Direct Provider / Vendor User Cancellation for Canceling User Access to the Caloms Treatment Data System - California

What Is Form DHCS5102 (ADP100180)?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DHCS5102 (ADP100180)?
A: Form DHCS5102 (ADP100180) is a form used for cancelling user access to the CalOMS Treatment Data System in California.

Q: What is CalOMS?
A: CalOMS stands for California Outcomes Measurement System. It is a data system used to collect information on substance use disorder treatment services in the state of California.

Q: Who can use the CalOMS Treatment Data System?
A: Direct providers, vendors, and county users can access and use the CalOMS Treatment Data System.

Q: What does the Form DHCS5102 (ADP100180) do?
A: The Form DHCS5102 (ADP100180) is used to cancel user access to the CalOMS Treatment Data System for a specific user.

Q: Who needs to fill out the Form DHCS5102 (ADP100180)?
A: The form needs to be filled out by the person or entity responsible for managing user access to the CalOMS Treatment Data System.

Q: Why would someone need to cancel user access to the CalOMS Treatment Data System?
A: User access may need to be cancelled if a person no longer requires access to the system or if there are security concerns.

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Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the California Department of Health Care Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form DHCS5102 (ADP100180) by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS5102 (ADP100180) Caloms Itws County / Direct Provider / Vendor User Cancellation for Canceling User Access to the Caloms Treatment Data System - California

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  • Form DHCS5102 (ADP100180) Caloms Itws County / Direct Provider / Vendor User Cancellation for Canceling User Access to the Caloms Treatment Data System - California, Page 1
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