Behavioral Health Templates

This form is used for referring a behavioral health advocate in Arizona. It is a document to request assistance from a professional to support mental health issues.

This Form is used for creating a Behavioral Health Advocacy Plan in Arizona.

This document is used for the attestation of Behavioral Health Worker Board Certified Assistant Behavior Analyst Provider Type 430 Specialty 151 in New Mexico.

This form is used for attestation by Behavioral Health Worker Registered Behavior Technicians or Board Certified Autism Technician Providers in New Mexico.

This document is a template used in New Mexico for the attestation of Behavioral Health Worker Non-certified Behavior Technician Provider Type 430 Specialty 098.

This form is used for summarizing consultation sessions with behavioral health professionals in Arizona.

This document is for applying for the Child Care Assistance Program (CCAP) in Rhode Island.

This form is used for referring individuals in South Carolina to rehabilitative behavioral health services.

This form is used for requesting a limit exception for rehabilitative behavioral health services in South Carolina.

This type of document is for obtaining accreditation for rehabilitative behavioral health services in South Carolina.

This document is a checklist used in Kentucky to identify individuals who have both behavioral health and chronic or complex physical health conditions. It helps healthcare providers assess and address the unique needs of these individuals.

This document is used to confirm the employment details of behavioral health providers under post-graduate supervision in the state of New Hampshire.

This form is used for documenting substance use disorder requirements for individuals receiving assistance through the Abd/Pwa program in Washington. It is important for individuals to complete this form accurately to ensure they meet the necessary requirements for continued assistance.

This document is used for completing the checklist required for an administrative separation related to behavioral health issues for enlisted members in the military.

This Form is used for updating or discharging a patient in Connecticut's Developmental Disabilities Administration Program (DDAP).

This form is used for screening the behavioral health of children between 6 months and 8 months of age in Oklahoma.

This form is used for screening the behavioral health of children aged 23 months to 28 months in Oklahoma.

This document is used for conducting a behavioral health screening for children between the ages of 15 months and 17 months in Oklahoma.

This form is used for screening the behavioral health of children between the ages of 9 months and 11 months in Oklahoma.

This Form is used for screening the behavioral health of children between 18 months and 22 months old in Oklahoma.

This Form is used for screening the behavioral health of children aged 4-17 years in Oklahoma.

This form is used for screening the behavioral health of children aged 35 months to 47 months in Oklahoma. It helps identify any potential issues or concerns for early intervention and support.

This type of document, DOH Form 670-147 Substance Use Disorder Professional Enhancement Plan (Ep) - Washington, is used for developing a plan to enhance the skills and knowledge of professionals working in the field of substance use disorder treatment in the state of Washington.

This document is a petition that can be used in South Dakota for requesting an emergency commitment for individuals who pose a threat to themselves or others.

This Form is used for requesting approval to remodel a Behavioral Health Agency in the state of Washington.

This document is used for applying for a Tribal Attestation Behavioral Health Agency License in Washington state.

This type of document is used for applying for psychiatric services in the state of North Carolina.

This document is used for making referrals to local mental and behavioral health authorities in Texas.

This form is used for applying to Behavioral Health Respite and Adult Therapeutic Homes in Arizona.

This monthly report is used for reviewing the conditional release of an individual who was acquitted of a crime due to insanity in Virginia's Department of Behavioral Health & Developmental Services.

This document provides information about a psychological application specific to North Carolina. It may involve various mental health services or resources available in the state.

This document provides information on the certification process for Behavioral Health professionals in the state of New Hampshire. It includes details on the requirements, application process, and resources available for individuals seeking certification in this field.

This type of document is a request for a Single Case Agreement for Residential Habilitation services in South Carolina.