Behavioral Health Services Provided Section
Does your organization provide outpatient Mental Health treatment?
ACT - Assertive Community Treatment
CPST - Community Psychiatric Support and Treatment
HCBS - Home and Community Based Services Program
PHP - Partial Hospitalization Program
PRTF - Psychiatric Residential Treatment Facility
PSR - Psychosocial Rehabilitation Services
Does your organization provide substance use disorder / addiction treatment?
MAT - Medication-Assisted Treatment
Does your organization provide residential Substance Use / Mental Health treatment?
What other general services does your organization provide?
Additional Requirements Section
Does your organization provide any of the following Tele-services?
Does your organization provide any of the following forms of transportation assistance?
Referral Process: Do you need to be referred to receive services?
Payments: Which form of payments does your organization accept?
Are there additional criteria for clients to receive services?
Is there public transportation available with one mile of your company/agency? (Does the city bus route have a stop within walking distance?)
Is there any additional information your agency/company would like to provide?
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