Forms

• CTS Form
• Standing Prior Approval (SPA) Form
• Single Trip Form
• Online MCA Form (it will generate a one-page PDF copy for your records after you click Send)
  • How to print/save MCA form instructions guide for Internet Explore
  • How to print/save MCA form instructions guide for Microsoft Edge
  • How to print/save MCA form instructions guide for Mozilla Firefox
  • How to print/save MCA form instructions guide for Google Chrome
• PDF MCA Form (please use only if you are not able to submit via Online MCA Form)
• Psychiatric Services Treatment Plan Form for CAP/GAP Providers
• Psychiatric Services Treatment Plan Form for Provider Type 36 (LPHAs)
  • Instructions for PSTP Provider Type 36 Form (LPHAs)
• HFS 3701T Therapy Prior Approval Request Form (if you are unable to view this form, right-click to save the file and then open it in Adobe Reader directly)
  • Instructions for HFS 3701T
• Complaint Form