California Code of Regulations
Title 15 - Crime Prevention and Corrections
Division 3 - Adult Institutions, Programs and Parole
Chapter 2 - Rules and Regulations of Health Care Services
Article 2 - Health Care Forms
Section 3999.99 - Forms

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

The following forms, referred to in this chapter, are hereby incorporated by reference:

CDCR 602 HC (Rev. 7/18), Health Care Grievance

CDCR 602 HC A (Rev. 12/17), Health Care Grievance Attachment

CDCR 1824 (Rev. 07/24), Reasonable Accommodation Request

CDCR 7225 (Rev. 03/19), Refusal of Examination and/or Treatment

CDCR 7362 (Rev. 03/19), Health Care Services Request Form

CDCR 7421 (Rev. 06/18), Advance Directive for Health Care

CDCR 7465 (Rev. 08/16), Physician Orders for Life-Sustaining Treatment

CDCR 7536 (Rev. 07/24), Durable Medical Equipment and Medical Supply Receipt

CDCR 7551 (07/24), Administration or Declination of Coccidioidomycosis Screening

CDCR 7701 (Rev. 10/20), Penal Code 2604 Rights

CDCR 7702 (Rev. 01/21), Petition for Capacity Determination

CDCR 7702-A (Rev. 10/20), Petition for Capacity Determination-Additional Page

CDCR 7703 (Rev. 01/21), Renewal Petition for Capacity Determination

CDCR 7704 (Rev. 10/20), Penal Code 2604 Reconsideration

CDCR 7705 (Rev. 10/20), Confidential Surrogate Decisionmaker Screening

CDCR 7706 (Rev. 10/20), Notice of Revocation or Termination of Penal Code 2604 Order

CDCR MH-7363 (Rev. 01/15), Involuntary Medication Notice

CDCR MH-7363-B (01/15), Involuntary Medication Notice: ADD-A-PAGE

CDCR MH-7366 (Rev. 01/15), Inmate Rights Notice -Involuntary Medication

CDCR MH-7368 (01/15), Renewal of Involuntary Medication Notice

CDCR MH-7368-B (01/15), Renewal of Involuntary Medication Notice: ADD-A-PAGE

CDCR MH-7369 (01/15), Penal Code Section 2602 Reconsideration

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code.

Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code.