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  • National Suicide Prevention Lifeline

    If you or someone you
    know is in crisis, call:

    800-273-8255
    (English/Spanish 24/7)

    Or chat with a crisis counselor:
    CHAT NOW

  • Get Services

    For mental health or substance use services, call intake:

    LA County:
    888-807-7250

    Orange County:
    714-547-0885

    Mon-Fri 8:30am-5:00pm

  • National Disaster Distress Helpline

    In distress because of a natural or human-caused disaster?

    Call for immediate
    counseling 24/7 at:
    800-985-5990

    Or text TalkWithUs to 66746

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    • Media Guidelines
  • Careers
  • About Us
    • COVID-19 Updates
    • Leadership
    • Locations
    • Partners, Grants & Contracts
    • Accreditations & Awards
    • Who Was Didi Hirsch?
  • Services
    • Suicide Prevention
    • Mental Health
    • Substance Use
  • Training
    • Suicide Prevention Training
    • Student Training Programs
    • Continuing Education
  • Impact
    • Erasing Stigma
    • Stories
    • Research & Evaluation
    • Annual Reports
    • Newsletters
    • Advocacy
  • Get Involved
    • Ways to Give
    • Events
    • Volunteer
    • Suicide Prevention Center Capital Campaign
  • Media
    • Media Queries
    • Recent Coverage
    • Press Releases
    • Media Guidelines
  • Careers
  • Client Info
  • DONATE
  • Get Help Now
  • National Suicide Prevention Lifeline

    If you or someone you
    know is in crisis, call:

    800-273-8255
    (English/Spanish 24/7)

    Or chat with a crisis counselor:
    CHAT NOW

  • Get Services

    For mental health or substance use services, call intake:

    LA County:
    888-807-7250

    Orange County:
    714-547-0885

    Mon-Fri 8:30am-5:00pm

  • National Disaster Distress Helpline

    In distress because of a natural or human-caused disaster?

    Call for immediate
    counseling 24/7 at:
    800-985-5990

    Or text TalkWithUs to 66746

Client Resources

  • Home
  • Client Resources

The following helpful resources are for Didi Hirsch clients:

Mental Health Forms

Substance Use Forms

Advanced Healthcare Directive Fact Sheet

Authorization For Request Or Use Disclosure Of Protected Information

Authorization For Request Or Use Disclosure Of Protected Information (Spanish)

Beneficiary Client Grievance Or Appeal And Authorization Form

Caregivers Affidavit

Client Request To Access PHI

Client Request To Access PHI (Spanish)

Consent For Electronic Communication

Consent For Observation

Consent For Services

Consent For Services (Spanish)

Consent Of Minor

Consent To Photograph Audio, Record Display Art Work

Financial Obligation Agreement

Financial Obligation Agreement (Spanish)

Financial Screening Checklist

Guide To Medi Cal Mental Health Services

Guide To Medi Cal Mental Health Services (Spanish)

Lifetime Extended Signature Authorization

Multiple Acknowledgment Receipt

Multiple Acknowledgment Receipt (Spanish)

Notice Of Privacy Practices

Notice Of Privacy Practices (Spanish)

Notice To Psychotherapy Clients For Licensed Registered Staff

Notice To Psychotherapy Clients For Licensed Registered Staff (Spanish)

Notice To Psychotherapy Clients For Unlicensed Unregistered Staff

Notice To Psychotherapy Clients For Unlicensed Unregistered Staff (Spanish)

Payor Financial Information

Provider List SPA 2

Provider List SPA 4

Provider List SPA 5

Provider List SPA 6

Provider List SPA 8

Telehealth Telephone Consent For Groups & Family Sessions

Telehealth Telephone Consent For Individual Services

Advanced Healthcare Directive Fact Sheet

Beneficiary Non Discrimination Notice

Client Request To Access PHI

Client Request To Access PHI (Spanish)

Compliant & Grievance Form

Compliant & Grievance Form (Spanish)

Consent For Electronic Communication

Consent For Services

Consent For Services (Spanish)

Consent To Photograph Audio, Record Display Art Work

DMC Multilple Acknowledgment Receipt Form

HIV TB Pamphlet

Multiple Party Authorization

Notice Of Privacy Practices

Notice Of Privacy Practices (Spanish)

Patient Handbook

Patient Handbook Summary

SAPC Release – In Network

SAPC Release – Out Network

Telehealth Telephone Consent For Groups & Family Sessions

Telehealth Telephone Consent For Individual Services

Your Rights Under Medi Cal

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Didi Hirsch MHSFollow

Didi Hirsch MHS
DidiHirschDidi Hirsch MHS@DidiHirsch·
19 Jun

“Incidence of PTSD was higher in health care professionals working during the COVID-19 pandemic than control group participants” – Psychiatry Advisor

Remember that Mental Health is Health. Check out http://didihirsch.org to learn more.

https://www.psychiatryadvisor.com/home/topics/anxiety/ptsd-trauma-and-stressor-related/ptsd-higher-in-health-care-professionals-especially-nurses-women-and-married-hcps-during-covid-19/

DidiHirschDidi Hirsch MHS@DidiHirsch·
18 Jun

“Higher levels of depression and anxiety may have impacted people’s exercise motivation during the pandemic.” – Very Well Mind

Don't forget that mental health is health!

https://www.verywellmind.com/pandemic-stress-and-anxiety-killed-exercise-motivation-5183966

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