Medical & Pharmacy Services

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)