Obtaining Consent

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Providers must obtain the voluntary written consent of the member or the member's parent or legal guardian before performing a Child Health and Disability Prevention (CHDP) program exam. Consent is also required for any release of medical information. The CHDP program has a standard consent form (PM 211 in English (PDF) and Spanish (PDF)) available to providers who do not have their own consent form for release of information.

If the member or member's parent or legal guardian refuses to have the exam or any portion of it performed, this information must be documented in the member's medical record and the county CHDP program should be informed. The provider may contact the county CHDP office directly, or contact Health Net's public programs administrator or the provider's affiliated plan for assistance.