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Behavioral Health & Substance Use Disorder Contract Request Form Along with this form, please complete the MN Uniform Practitioner Change Form for each practitioner at your location(s) & Submit a

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Behavioral health refers to the connection between behaviors and the health and well-being of the body, mind, and spirit. It encompasses mental health, substance use, and other behaviors impacting a person's overall health.

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Individuals and organizations that provide mental health and substance use treatment services, including healthcare professionals and facilities, may be required to file, as mandated by state or federal regulations.

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To fill out the behavioral health and substance reporting forms, gather required data such as patient demographics, service type, and treatment outcomes. Follow the specific guidelines outlined by the reporting agency to ensure all necessary information is included.

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The purpose is to collect and analyze data related to behavioral health services, monitor treatment effectiveness, ensure compliance with regulations, and improve overall public health outcomes.

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Information typically includes patient demographics, service types provided, duration of treatment, treatment outcomes, and any relevant diagnostic information.

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