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Every Woman Counts (EWC) Manuals, Forms and Worksheets

Every Woman Counts (EWC) Step-By-Step Provider User Guide

Consent to Participate in Program (Provider Use Only) Note:

The Consent to Participate in Program will be available in other languages at a later date.


Notice of Privacy Practices Form

The Notice of Privacy Practices (English Form) can be downloaded from the Notice of Privacy Practices page of the DHCS website.

Note:

The Notice of Privacy Practices Form will be available in other languages at a later date.


Recipient Eligibility Forms (Provider Use Only)

Breast and Cervical Screening Cycle Data Worksheets & Instructions Covered Procedures
  • Breast Only Primary Care Provider Covered Procedures (under revision)
  • Breast & Cervical Primary Care Provider Covered Procedures (under revision)
  • Referral Provider Covered Procedures (under revision)


Note:

If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.