Children's Behavioral Health - Forms

Forms and instructions for accessing Children’s Behavioral Health Services


Application to Become a CBHS Service Provider

CBH Provider Website Update Form

PRTF Provider Application

CBHS Data Request Form

Reportable Events

EIS New Provider Request Access Form

User EIS access is done electronically in EIS

Individual Planning Funding Application


Home and Community Based Treatment HCT

Intensive Temporary Residential Treatment

Release of Information

  • Authorization to Release Information (PDF* )

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

Targeted Case Management