Children's Mental Health Provider Forms

Effective January 1, 2020, in partnership with Telligen, Mountain-Pacific will provide the utilization and review of behavioral health services provided by Children's Mental Health.  Please check out the Mountain Pacific Quality Health Website for forms, education, training and contact information.

Home Support Services

Integrated Co-Occurring Treatment (ICT)

Mountain Pacific Quality Health Forms for Psychiatric Residential Treatment Facilities

Non-Medicaid Services Forms

Psychiatric Residential Treatment Facilities (PRTF/PRTF-AS)

Serious Emotional Disturbance (SED) Diagnosis

Therapeutic Group Home

Developmental Services Division

Children’s Mental Health Bureau

Crisis Text Line - A free, 24/7 text line for people in crisis.  Text "MT" to 741 741

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Montana Suicide Prevention Information and Resources

 


Regional Resource Specialists

Theresa Holm  406-444-2958, Fax 406-444-5913
Blaine, Big Horn, Broadwater, Carbon, Cascade, Choteau, Fergus, Gallatin, Glacier, Golden Valley, Hill, Jefferson, Judith Basin, Lewis & Clark, Liberty, Madison, Meagher, Musselshell, Park, Petroleum, Phillips, Pondera, Roosevelt, Rosebud, Silver Bow, Stillwater, Sweet Grass, Teton, Toole, and Wheatland

Trish Christensen, 329-1330 (P), 329-1332 (F)
Beaverhead, Carter, Custer, Daniels, Dawson, Deer Lodge, Fallon, Flathead, Garfield, Granite, Lake, Lincoln, McCone, Mineral, Missoula, Powder River, Powell, Prairie, Ravalli, Richland, Sanders, Sheridan, Treasure, Valley, Yellowstone, and Wibaux

CMHB Staff Directory

Utilization Review:
Mountain-Pacific Quality Health
 
Telligen 1-800-219-7035

Children's System of Care (SOC) Planning Committee

Trauma Resource List for Teachers