Behavioral Health

Common Forms

Documents for behavioral health providers

Behavioral Health–Authorization Request Form (BH-ARF) Download PDF Icon Submit along with clinical documentation to request a review to authorize behavioral health services. For Applied Behavior Analysis (ABA), please use the BHT-ARF form.

Behavioral Health Treatment-Authorization Request Form (BHT-ARF) Download PDF Icon Submit along with clinical documentation to request a review to authorize BHT/ABA service.

Psychological Testing Pre-Authorization Request Form Download PDF Icon You must submit this form to pre-authorize all psychological testing

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