Children's Behavioral Health - Forms

Forms and instructions for accessing Children’s Behavioral Health Services:  MaineCare RCS (Rehabilitative and Community Support Services);
MaineCare  HCT(Children’s Home and Community Based Treatment)

Assessments

Application to Become a CBHS Contracted Service Provider

CBH Provider Website Update Form

Contracted Provider Critical Incident Reporting


EIS Staff Update Form

Individual Planning Funding Application

Grievance

Home and Community Based Treatment HCT

Intensive Temporary Residential Treatment

OQMHP-PNMI

  • Training record (Word* | also in PDF*)

Release Information

  • Authorization to Release Information (Word* | also in PDF*)

Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations (RCS 28)

Targeted Case Management