Provider Forms

To save Forms:

Right click on any of the links below and select "Save Target As.." from the pop up menu.

New and Improved Clinical Forms

Psychiatrists, Physician's Assistants, and Nurse Practitioners

Clinical Assessment Report and Treatment Plan (Initial Visits)

ECT Authorization Request

Progress Report

Additional Notes (optional)

Psychologists and Master's-Prepared Therapists

Clinical Assessment Report and Treatment Plan (Initial Visits)

Progress Report

Additional Notes (Optional)

Psychological Testing Form

Other Documents

Patient Information Form

BHS Provider Guide

Provider Update Form

Provider Profile

W-9 Form

Recredentialing Application

If you need previous versions of any forms, please contact the BHS Provider Relations Division at (800) 245-1150.