HHS Forms & Documents

Documents / Reference

• Crisis resources (PDF)
• HHS Master List of Acronyms(PDF) (PDF)
• HHS New Employee Orientation Guide with videos. (PDF)
• OHP MED Dual Diag (PDF)
• PRIDE form (PDF format) (PDF)
• Redundant Communications March 27, 2003 (PDF)
• Vicarious Trauma Peer Consultation Brochure (PDF)
• YCCO MH Levels of Care Model (PDF)
• YCHHS Service Code Guide (XLSX)

Emergency Evacuation Procedures

• Campus Map Assembly Points (PDF)
• Evacuation Policy Procedures (DOCX)

Forms

• Adult Abuse Reporting Form - MH (PDF)
• Client No Show Referral follow up (NSRF) (DOCX)
• Critical Incident form (PDF)
• Electronic Communication With Clients (PDF)
• Expense Form (PDF)
• Expense Form Instructions (DOCX)
• Fraud Waste Abuse Reporting Form Fillable (PDF)
• Grievance Resolution Letter non-YCCO Member (PDF)
• Grievance Resolution Letter YCCO Member (PDF)
• HHS Request for Special Work Hours (PDF)
• HIPAA incident reporting form (PDF)
• OHP Complaint Form (English) (PDF)
• OHP Complaint Form (Spanish) (PDF)
• Overnight Travel Form Instructions (DOCX)
• Overnight Travel Information Form (XLSX)
• Patient Admit to BH status ltr to PCP (PABH PCP) (DOCX)
• Payroll Correction Form 2021-2023 (PDF)
• Referral for BH services (Ref-BH) (DOCX)
• Special Needs Request Instructions 7.1.21 (DOCX)
• Special Needs Request modified January 1, 2022 (PDF)
• Training Database Workflow (Word Document) (DOCX)
• Transport Adult Non-Client Hold Harmless Agreement (PDF)
• Transport Adult Non-Client Hold Harmless Agreement (Spanish) (PDF)
• Transport Minor Non-Client Hold Harmless Agreement (PDF)
• Transport Minor Non-Client Hold Harmless Agreement (Spanish) (PDF)
• YCHHS Complaint Process (English) (PDF)
• YCHHS Consent to Treatment (PDF)
• YCHHS Transfer of Care to PCP Ltr (TOC-PCP) (DOCX)

Org Charts

• ABH Org Chart (PDF)
• Core Office Support Org Chart (PDF)
• CSS Org Chart (PDF)
• DD Org Chart (PDF)
• ERO Org Chart (PDF)
• Fiscal Year Org Chart (PDF)
• HHS Administration Org Chart (PDF)
• HHS Org Chart (PDF)
• PH Org Chart (PDF)

Technology Support

• Change Raintree P-Word (PDF)
• Change Windows P-Word (PDF)
• Computer Policy (PDF)
• Computer Support Contacts for HHS (PDF)
• Using Secure Email (PDF)
• Video Conferncing Instructions (PDF)
• Strong Passwords

Time Sheets

• HHS Timesheet - Contract (PDF)
• HHS Timesheet - Hourly and Part Time (PDF)
• HHS Timesheet - Salaried (PDF)
• Public Health Timesheet (XLSX)