BEHAVIORAL HEALTH
Behavioral Health
Umpqua Health Alliance (UHA) is committed to supporting our members with Intensive Care Coordination by utilizing all available resources to improve their physical health and mental well-being. In addition, UHA covers Behavioral Health Services for all members and are designed to empower members to live, work, and thrive in their communities.
Forms
- Behavioral Health Referral Matrix
- Case Manager Referral Form
- Hepatitis C Case Management Referral Form
- Health Related Services Form
- Coordination of Benefits Intake Form
- New Day – Pregnant Mom Program Flier
- New Day Program Referral Form
- New Beginnings – Age 0 to 5 Program Flier
- Barrier Submission Form
- Barrier Submission Form Process
- Psychological Evaluation Request Form
- Support and Success Funding Application | W9
- Application for Certification Training in Disordered Eating
Contact Us
For all referral questions, please contact us at CaseManagement@umpquahealth.com.
