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Medical & Pharmacy Services
Page Content
Medication Practice Guidelines
Santa Clara County Behavioral Health Services Department Medication Practice Guidelines
Medication Guideline Appendices
Medication Consent Forms
Standardized Medication Consent Form: English
Medication Consent Forms (Chinese)
Medication Consent Forms (Spanish)
Medication Consent Forms (Tagalog)
Medication Consent Forms (Vietnamese)
Miscellaneous Forms
Prior Authorization Forms
Abilify Criteria for Use fill In Form (Final) 11/29/11
Abilify Criteria for Use Memo 11/29/11
Blank QI form 08/2012
Quality Improvement Medication Monitoring Form (Sample Form) rev. 8/2012
Physician's Order Form 5/1983
Patient Education Material
Medication for Mental Health (English) rev. 11/2006
Medication for Mental Health (Chinese) rev. 08/17/07
Medication for Mental Health (Spanish) rev. 10/05/07
Medication for Mental Health (Tagalog) rev. 10/05/07
Medication for Mental Health (Vietnamese) rev. 10/05/07
Miscellaneous
Abnormal Involuntary Movement Scale (AIMS) 10/2007
VMC Pharmacy Hours rev. 05/10/17
Client Injectable Medication Log sheets 03/02/07
Hamilton Depression Rating Scale (HDRS)
Hamilton Anxiety Rating Scale (HAM-A)
Y-BOCS Symptom Checklist
Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist
Patient Health Questionnaire-9 (PHQ-9)
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