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Important Message From NLACRC

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All NLACRC offices will be closed on Thursday, June 19th, in observance of Juneteenth. Regular business hours will resume on Friday, June 20th.

If you have a medical emergency, please call 9-1-1. For urgent issues, call our 24-hour, after-hours phone line at (818) 778-1900.

NLACRC has launched our VENDOR PORTAL! If you have questions or have not yet registered, please contact vendorportal@nlacrc.org.

Service Providers Forms and Policies

Service Provider Forms

download this documentVendor Address Change Form download this documentCertificate of Return or Destruction of PHI Form download this documentSpecial Incident Report (SIR) Form

Service Provider Policies

download this documentConflict-of-Interest Policy download this documentContract Policy download this documentDrug-Free Workplace Policy download this documentHIPAA Business Associates Agreement download this documentOut of Community State-Travel Guidelines for Residential Providers download this documentOut of Community State-Travel Guideline for SLS download this documentRecovery Policy download this documentReporting Security Incidents Involving Paper, Electronic Records, or Other Formats download this documentRequest for Proposals Policy download this documentService Provider Attendance Policy download this documentService Provider Insurance Policy download this documentTransparency and Public Information Policy download this documentWhistleblower Policy for Vendors, Contractors & Others download this documentZero Tolerance Policy for Consumer Abuse or Neglect