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Intensive Behavioral Health Services (IHS) Written Order Letter Child's Name:Date of Birth:MA ID#:Today's Date:___Parent/Guardians Name(s): Address: ___ Phone number:___ School (if applicable): Other
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How to fill out intensive behavioral health services

01
Contact your healthcare provider or mental health professional to discuss if intensive behavioral health services are appropriate for you.
02
Obtain a referral from your healthcare provider to an intensive behavioral health services provider.
03
Schedule an intake appointment with the provider to assess your needs and develop a treatment plan.
04
Follow the recommendations and guidelines provided by the provider for participating in the intensive behavioral health services program.
05
Attend all scheduled appointments and actively participate in therapy sessions and activities to maximize the benefits of the services.

Who needs intensive behavioral health services?

01
Individuals who are experiencing severe mental health symptoms or conditions that significantly impact their daily functioning.
02
People who have not responded well to traditional outpatient therapy or medication management.
03
Individuals who require more intensive and structured support to address their mental health concerns.
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Intensive behavioral health services are comprehensive mental health treatment programs that provide a structured and intensive level of care for individuals experiencing significant mental health challenges.
Providers of mental health services, including but not limited to therapists, psychologists, and psychiatrists, are required to file intensive behavioral health services.
To fill out intensive behavioral health services, providers must include detailed information about the individual receiving services, the type of services provided, the goals of treatment, and progress made towards those goals.
The purpose of intensive behavioral health services is to support individuals in achieving improved mental health outcomes through a targeted and intensive treatment approach.
Information that must be reported on intensive behavioral health services includes diagnosis, treatment plan, progress notes, outcomes, and any changes in the individual's mental health status.
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