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ELECTRONIC FORM

Electronic Forms

This page contains links to forms that can be completed electronically on your computer or mobile device. The forms list is divided into two sections:
1. Forms that can be completed at any time.
2. Forms that should only be completed when you're instructed by staff

Electronic Forms for Mental Health Services

The following forms can be completed/used at any time

Telemedicine Consent Form
Electronic Referral Form
Release of Information

Forms should only be completed when requested by MNCP staff

Service/Treatment Plan Signature Page
UCare ARMHS Provider Form
Electronic Intake Forms

Electronic Forms for Roots Recovery SUD Services

The following forms can be completed/used at any time

Telemedicine Consent Form
Electronic Referral Form
Release of Information

Forms should only be completed when requested by MNCP staff

Treatment Plan Acknowledgement
Intake & Billing Consent Forms

Paper/PDF Forms for Download

If you have barriers to using the electronic documents, or just find paper/pen more convenient, we offer PDF and Word Doc versions of our Intake Formset here:

Mental Health Intake Formset – PDF
Mental Health Intake Formset – Word Doc