Intensive Behavioral Health Services (IBHS) Forms
- FFT Booster Session Request Form (PDF)
- IBHS Discharge Summary Form (PDF)
- IBHS Fee-for-Service (FFS) to PerformCare Transition Form (PDF)
- IBHS Flexible Outpatient Therapy Registration Form (PDF)
- IBHS Individual/ABA Provider Choice Acknowledgment Form (PDF)
- IBHS Initial Service Capacity Acknowledgement for Individual IBHS and ABA IBHS (PDF)
- IBHS Provider Choice Form — Capital (Cumberland, Dauphin, and Perry) (PDF)
- IBHS Provider Choice Form — Capital (Lancaster and Lebanon) (PDF)
- IBHS Provider Choice Form — TMCA (PDF)
- IBHS Written Order Recommendation Guidelines (PDF)
- IBHS Written Order Process Resource Document (PDF)
- IBHS Written Order Form (PDF)
- Multisystemic Treatment (MST) Provider Choice Form (PDF)