Vermont Department of Mental Health Forms

This form is used for submitting personal expenses for reimbursement in the state of Vermont. It allows individuals to record and itemize their expenses and provide supporting documentation for reimbursement purposes.

This Form is used for applying for non-emergency services in Vermont. It helps individuals to request and access the necessary assistance they need.

This form is used for screening individuals who are going through the court process in Vermont. It helps gather important information about the individual's background and circumstances.

This document is a Grievance or Appeal Form used in Vermont for the DA/Ssa. It is used to formally address concerns or challenges with regards to a decision made by the DA/Ssa.

This document is used for establishing an agreement for placing a child in an out-of-home setting in the state of Vermont.

This form is used for determining the eligibility of students for new enrollment, reenrollment, or transfer enrollment in Vermont.

This Form is used for pre-assessment screening and resident review in Vermont for individuals with mental illness, intellectual disability, or related conditions.

This document is a second certification short form of a psychiatrist's certificate. It is specific to the state of Vermont.

This Form is used for certifying the involvement of a second psychiatrist in the treatment plan for a patient in Vermont.

This application is used for individuals who wish to become a Commissioner-Designated Qualified Mental Health Professional (QMHP) in Vermont.

This document is used for requesting special services funding for Community Rehabilitation & Treatment Services (CRT) in Vermont. It helps to support the rehabilitation and treatment of individuals in the community.

This form is used for requesting funding for special services in the state of Vermont.

This document is a technical guide for the Pasrr Level I Form in Vermont. It provides information on how to properly complete the form for medical evaluation purposes.

This document is a proposal request for individual outlier funding in the state of Vermont. It is used to seek funding for specific projects or initiatives that are outside the norm or considered unconventional.

This form is used for requesting funding authorization for child, adolescent, and family services in the state of Vermont.

This document outlines the Corrective Action Plan (CAP) for the state of Vermont under the DMH (Department of Mental Health). It details the steps that will be taken to address any identified issues or concerns and improve the mental health services provided in the state.

This form is used for calculating and reporting any underpayment of estimated individual income tax owed to the state of Vermont.

This document is used to apply for an emergency examination in the state of Vermont.