California 7478 form-2026

1. Click ‘Get Form’ to open the California 7478 form in the editor.
2. Begin with Section 1: Inmate Information. Fill in the inmate's name, CDC number, current housing/placement, date of birth, and the date as of which this information is relevant.
3. Proceed to Section 2: Medical Information. Clearly print the diagnosis and prognosis. List the current medical/physical condition by detailing abilities and limitations for each activity such as breathing, eating, bathing, dressing, transferring, elimination, arm use, and ambulation.
4. If applicable, complete Section 3 for requests made by a family member or designee. Include the requestor’s name, date of request, and their relationship to the inmate.
5. In Section 4: Consent for Release of Medical Information, check the appropriate box regarding consent status and provide details about the primary care physician.
6. Continue to Sections 5 and 6 for eligibility approvals and placement plan approvals. Ensure all required signatures are obtained from relevant authorities.

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