Provider Forms, Policies & Documents

This is the main page for Behavioral Care Network provider forms. Most of the forms a provider might need are available on this page.

You may be able to fill some of these forms on your computer, then print, sign (if necessary) and submit via instructions on the form. Here you’ll find the most commonly used documents in Adobe .pdf format (unless otherwise noted).

About PDFs: You can save a blank version of the form. To view PDF documents you need Adobe Acrobat Reader, provided free from Adobe.com.

 

Please contact our Provider Relations Coordinator Martha Arevalo at 503-566-2916 if you have questions or need assistance.

Downloadable Forms

Adult Crisis Prevention PlanCAMS Training ReimbursementCritical Incident NotificationCritical Incident Follow UpDeclaration for Mental Health TreatmentFlexible Services RequestFFS Reimbursement Schedule for In-Panel OP MH Services
Practitioner Reg Form LicensedMetabolic MonitoringPractitioner-Reg-Form-Non-LicensedOut of Panel AgreementOut of Panel Request FormPHTech 3108 EnrollmentW-9Youth Crisis Prevention Plan