• Primary Care Physician Referral Form: Word document
  A note to Primary care Physicians: We have expanded our web-based referral capabilities that results now in the fastest way to submit a complete referral. For more information about this, or to become a registered user, please e-mail Sally Chambers at schambers@kbhmaine.org
• Wraparound Referral Form: Word document
• Central Access Form: Word document
• Orientation Manual: pdf document
• Orientation Intake Consent for Treatment: Word document
• HIPAA Consent for Purposes of Treatment, Payment and Operations: Word document
• Release of Information Forms
  • Augusta Word document
  • Skowhegan: Word document
  • Waterville: Word document
  • Winthrop: Word document
• Notice of Privacy Practices: Word document
• Multisystemic Therapy
  • Referral Screening Form: Word document
• Home and Community Treatment (HCT)
  • HCT program description Word document
  • HCT referral form pdf | Word document
  • HCT referral form instructions/walk-through pdf | Word document

For Department of Health and Human Services Referrals Only:
Have you longed for the day when making a referral was less complicated and more efficient? If so, consider entering your referral directly online in our secure Access entry system. For more information on this confidential site and to register, please contact schambers@kbhmaine.org.

• Office of Child and Family Services Referral Checklist: Word document
• Orientation Manual: pdf document
• Orientation Intake Consent for Treatment: Word document
• HIPAA Consent for Purposes of Treatment, Payment and Operations: Word document
• Release of Information Forms
  • Augusta Word document
  • Skowhegan: Word document
  • Waterville: Word document
  • Winthrop: Word document
• Notice of Privacy Practices: Word document
• Multisystemic Therapy Referral Form: Word document

• Department of Corrections Referral Checklist: Word document
• Central Access Form: Word document
• Orientation Manual: pdf document
• Orientation Intake Consent for Treatment: Word document
• HIPAA Consent for Purposes of Treatment, Payment and Operations: Word document
• Release of Information Forms
  • Augusta Word document
  • Skowhegan: Word document
  • Waterville: Word document
  • Winthrop: Word document
• Notice of Privacy Practices: Word document
• Multisystemic Therapy Referral Form: Word document

• Standards of Conduct/Corporate Compliance Program