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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DHCS1801
for the current year.
Form DHCS1801 Application for up to 72-hour Assessment, Evaluation, and Crisis Intervention or Placement for Evaluation and Treatment - California
What Is Form DHCS1801?
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 DHCS1801?A: Form DHCS1801 is an application for up to 72-hour Assessment, Evaluation, and Crisis Intervention or Placement for Evaluation and Treatment in California.
Q: What is the purpose of form DHCS1801?A: The purpose of form DHCS1801 is to request a temporary hold for assessment, evaluation, crisis intervention, or placement for evaluation and treatment in California.
Q: Who can fill out form DHCS1801?A: Form DHCS1801 can be completed by a qualified person, such as a mental health professional or authorized designated person, in California.
Q: What information is required on form DHCS1801?A: Form DHCS1801 requires information about the individual being assessed, including their name, contact information, reason for assessment, and signatures of the qualified person completing the form.
Form Details:
- Released on December 1, 2019;
- 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;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS1801 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form DHCS1801 Application for up to 72-hour Assessment, Evaluation, and Crisis Intervention or Placement for Evaluation and Treatment - California
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