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STATE OF NEW HAMPSHIRE
Department of Health and Human Services
Division for Children, Youth and FamiliesForm 2617R
October 2016CERTIFICATION RENEWAL PRIVATE BEHAVIORAL HEALTH SERVICES PROVIDERS
Provider
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How to fill out private behavioral health services
How to fill out private behavioral health services
01
Find a reputable behavioral health service provider
02
Schedule an initial evaluation or assessment
03
Provide necessary personal information and medical history
04
Work with the provider to create a treatment plan
05
Attend scheduled therapy sessions or treatments
06
Follow any additional recommendations or guidelines provided by the provider
Who needs private behavioral health services?
01
Individuals struggling with mental health disorders such as anxiety, depression, bipolar disorder, or PTSD
02
Individuals experiencing significant stress, trauma, or life changes
03
Individuals looking to improve their overall mental well-being or seeking counseling for personal growth
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What is private behavioral health services?
Private behavioral health services are mental health and substance abuse services that are provided by private healthcare providers or facilities.
Who is required to file private behavioral health services?
Providers of private behavioral health services are required to file reports with the appropriate regulatory agencies.
How to fill out private behavioral health services?
Private behavioral health services should be filled out using the designated forms provided by the regulatory agencies.
What is the purpose of private behavioral health services?
The purpose of private behavioral health services is to ensure that individuals receive proper mental health and substance abuse treatment.
What information must be reported on private behavioral health services?
Information required to be reported on private behavioral health services includes patient demographics, diagnoses, treatment plans, and outcomes.
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