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Provider Forms
Click on the links to open the forms.
All the forms will be in pdf format unless otherwise stated.
Critical Incident Provider Report Form 02/20/08
OP Instructions 06/01/06
Request for NeuroPsychological and Psychological Testing 07/15/08
Substance Abuse Outpatient Registration Form 02/20/08
Mental Health Outpatient Registration Form 02/20/08
* Gateway Health Plan
®
at a Glance for Behavioral Health Services
* This document provides quick reference to instruction for authorization as well as critical phone numbers. It also includes detailed instruction for Providers to confirm membership in the Gateway
Medicare Assured
SM
Plan.
