Health Program
freedom of independent thinking, training & transition
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Required forms for ADHC admission:
- Referral Intake Form
- Copy of client's Medi-Cal Card or POS from Kern Regional Center (unless you are private pay)
- PCPR (Primary Care Physician Release) Form (Required by Medi-Cal for ADHC Eligibility)
- Completed Medical History & Physical (performed within the last 90 days) and related forms
- TB Clearance form (current TB test of chest x-ray performed within the last 12 months)
- Any Blood Pressure and Blood Sugar Parameter Monitoring
- Current medication profile and diagnosis
- Current diet orders with indication for special dietary needs (if required)
- Occupational/Physical Therapy Orders
- Psychological Evaluation completed within the last 12 months
- IPP and/ or Initial evaluation from Regional Center or Mental Health
- Any hospital or institution discharge forms
- Any other medical records
If you have questions, or require assistance, please contact our admissions department at 322-4085.
Our Admissions office is open Monday through Friday from 7:30am to 3:30pm.
Freedom Of Independent Thinking, Training & Transition
Phone: (661)322-4085
Fax: (661)323-1059
