Behavioral Health Services Provided Section
Does your organization provide outpatient Mental Health treatment?
CPST - Community Psychiatric Support and Treatment
HCBS - Home and Community Based Services Program
PSR - Psychosocial Rehabilitation Services
Does your organization provide substance use disorder / addiction treatment?
ASAM Level I - Addiction Outpatient Treatment Program
Does your organization provide residential Substance Use / Mental Health treatment?
What other general services does your organization provide?
Substance Use Disorder Counseling
Additional Requirements Section
Does your organization provide any of the following Tele-services?
Referral Process: Do you need to be referred to receive services?
If Yes, please describe the referral process?
Request, complete, and submit form. Self referral available.
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?