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Amilcare Inc. Addictions & Mental Health Services Authorization Form Phone: 877-225-2243 / 503-345-5704 Fax: 503-345-5770 Today s Date: Member s Name: DOB: Recipient ID#: Referring Provider: Phone:

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What is familycare inc addictions amp?

Familycare Inc Addictions AMP is a form used to report information about addiction services provided by the organization.

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Familycare Inc is required to file the Addictions AMP form.

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Familycare Inc must fill out the Addictions AMP form with detailed information about addiction services provided.

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The purpose of the Addictions AMP form is to report on addiction services provided by Familycare Inc.

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Familycare Inc must report detailed information about the addiction services provided, including the types of services, demographics of clients served, and outcomes.

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