Referral & Application Process


260 E. 15th St.
Merced, CA 95341
Ph: (209) 381-1114
Fx: (209) 724-4001

How are CCS Services Obtained?

  • Referrals can be submitted by any agency involved with the child's care including physicians, hospitals, nurses, school districts, Regional Center, or the client or family directly.
  • A referral must include appropriate medical reports to confirm the medical condition, a Service Authorization Request that specifies what services are being requested from CCS, and a signed program application.
  • The documents should be sent to the Merced County CCS office.


Please submit both the referral and application form:

CCS Application for Services (To be completed by parent / legal guardian)
Solicitud en español para servicios de CCS debe ser completado por padre o guardian legal
Established CCS/GHPP Client Service Authorization Request (SAR)
New Referral CCS/GHPP Client Service Authorization Request (SAR)