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. 28, July 12, 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. 09/17), 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. 05/17), Durable Medical Equipment and Medical
					 Supply Receipt
CDCR 7551 (01/16), 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
1. Change without
					 regulatory effect adopting section filed 8-6-2018 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2018, No. 32).
2. Amendment filed 3-12-2019 as an
					 emergency; operative 3-12-2019 (Register 2019, No. 11). Pursuant to Penal Code
					 section
					 5058.3, a
					 Certificate of Compliance must be transmitted to OAL by 8-19-2019 or emergency
					 language will be repealed by operation of law on the following day.
3.
					 Change without regulatory effect adopting new article 2 heading and amending section
					 filed 4-15-2019 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2019, No. 16).
4. Amendment filed 7-1-2019 as an
					 emergency; operative 7-1-2019 (Register 2019, No. 27). Pursuant to Penal Code
					 section
					 5058.3, a
					 Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency
					 language will be repealed by operation of law on the following day.
5.
					 Editorial correction adding inadvertently omitted form (Register 2019, No.
					 27).
6. Certificate of Compliance as to 3-12-2019 order transmitted to
					 OAL 8-14-2019 and filed 9-24-2019 (Register 2019, No. 39).
7. Amendment
					 refiled 12-5-2019 as an emergency; operative 12-10-2019 (Register 2019, No. 49).
					 Pursuant to Penal Code section
					 5058.3, a
					 Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency
					 language will be repealed by operation of law on the following day.
8.
					 Amendment refiled 3-9-2020 as an emergency; operative 3-10-2020 (Register 2020, No.
					 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency
					 language will be repealed by operation of law on the following day.
9.
					 Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed
					 7-20-2020 (Register 2020, No. 30).
10. Amendment filed 3-1-2021;
					 operative 3-1-2021 pursuant to Government Code section
					 11343.4(b)(3)
					 (Register 2021, No. 10).
11. Amendment filed 10-28-2021; operative
					 1-1-2022 (Register 2021, No. 44). Filing deadline specified in Government Code
					 section
					 11349.3(a)
					 extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60
					 calendar days pursuant to Executive Order N-71-20.
Note: Authority cited: Section
						5058, Penal Code.
						Reference: Section
						5054, Penal
						Code.
The amended version of this section by
					 Register
					 2024, No. 28, effective 7/1/2024 is not yet
					 available.