Free and confidential services and help, available 24/7. Recovery is nurtured by relationships and environments that provide hope, empowerment, choices and opportunities. Learn more about DBHDD's... Code Section 50-21-35 provides in relevant part:

If you are a current DBHDD Provider, you can register for and access the DBHDD Applications available to you at the DBHDD Applications website. This site contains the online provider applications that DBHDD hosts.

DBHDD DBHDD HIPAA Complaint Form DBHDD HIPAA Violation Report Form Information on how to report abuse, neglect, or exploitation

Those interested in becoming a host home provider should contact an approved DBHDD provider of CRA services. To locate DBHDD-approved CRA providers in your area, you can utilize the Provider Search website.

Download and print the following forms: Application for Intellectual/Developmental Disabilities Services Authorization for Release of Information Form (Attachment A) Notice of Privacy Practices Policy (Attachment A) Mail the completed forms to …

With this Letter of Intent to Provide Services Form, your organization must also submit all pre-qualifiers listed within the Recruitment and Application to Become a Provider of Developmental Disabilities Services Policy.

DBHDD Applications

Constituent Services Intake Form Human Rights Council External Referral Form Victim Notification Opt-In

Sep 26, 2023 · As of August 2023, we have added a requirement to include the International Classification of Disease (ICD) code to identify the exact diagnosis so that the receiving provider can enter it correctly into their own electronic health record.

Mar 14, 2025 · This is a simplified disability verification form for DBHDD providers to use with their application to HCV via DCA. It does not require a clinical approval and does not include diagnosis information, so a standard case manager role is allowed to complete it and sign.