Don't Lose Your Medi-Cal Coverage! Please completely fill in ALL areas to include the following: • Patient Information: Patient Name, Patient Date of Birth and Phone. Number.Print and complete the Alameda County Behavioral Authorization to Disclosure Psychotherapy Notes form: English (PDF). Blank Application Forms. The below forms may be dropped at a secure drop box, at one of our offices, during regular business hours, am to pm. Children First Medical Group Phone Number: 1.510.428.3154. , (an adult into whose care the minor has been entrusted) to consent to medical treatment of. Each time the child or youth needs to see a new doctor, get new medication, or equipment, a Service Authorization Request form (SAR) needs to be completed. If you do not have network access please fill out a Network Access form. If you have any questions, please call the Help Desk at 510-567-8181.