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Oregon Behavioral Health Support Program
Please submit form CH-002 when an individual moves out of an adult foster care or residential treatment program for behavioral health services.
Oregon Behavioral Health Support Program
Please submit form CH-003 to request an individually-based limitation (IBL).
Oregon Behavioral Health Support Program
Please submit form CH-006 to request a plan of care for adult foster care or residential personal care/habilitation services.
Oregon Behavioral Health Support Program
Please complete form CH-007 to request prior authorization of Psychosocial Rehabilitation Services (outpatient rehabilitation).
Oregon Behavioral Health Support Program
Please complete form CH-008 to request authorization for crisis respite stays for individuals in residential and adult foster home settings. To be completed by crisis respite provider.
Oregon Behavioral Health Support Program
Please complete form CH-010 to refer an individual for OBHSP Behavioral Health Personal Care Attendant (BH PCA) services (reference OAR 410-172-0790).
Consent for Release of Information and Participation in the Oregon Behavioral Health Support Program
Oregon Behavioral Health Support Program
Please complete this form to give your consent to use and disclose your PHI.
Oregon Behavioral Health Support Program