COVID-19 Updates
MyChart
logologo2x

COVID Vaccine Updates: Learn more about vaccine eligibility and availability in your community.

  • Find a Doctor
  • Departments
       

    Departments

    • Behavioral Health
    • Brain and Spine
    • Cancer
    • Chaplain Services
    • Children's Health
    • Classes & Events
    • Dermatology
    • Diagnostic Imaging
    • Employer and Workplace Services
    • ElderPlace
    • ExpressCare
    • Financial Assistance
    • Foundations
    • Graduate Medical Education and CME

     

    • Heart and Vascular
    • Home Services
    • Laboratory Services
    • Online Doctor Visits
    • Orthopedics
    • Pharmacy Services
    • Pregnancy, Labor and Birth
    • Providence Medical Group
    • Rehabilitation
    • Research
    • Sports Medicine
    • Surgical Services
    • Urgent & Immediate Care
    • View all departments and services ›
  • Locations & Clinics
       

    Hospitals

    • Providence Hood River Memorial Hospital
    • Providence Medford Medical Center
    • Providence Milwaukie Hospital
    • Providence Newberg Medical Center
    • Providence Portland Medical Center
    • Providence Seaside Hospital
    • Providence St. Vincent Medical Center
    • Providence Willamette Falls Medical Center

    Pharmacy

    • Retail Pharmacies

    Emergency

    • Emergency Departments

    Urgent and Immediate Care

    • ExpressCare Clinics
    • Immediate Care Clinics
    • Online Doctor Visits

    Clinics & Labs

    • Laboratory Services
    • Occupational Medicine Clinics
    • Physical Rehabilitation Clinics
    • Primary Care Clinics
    • Specialty Care Clinics

    • View other locations ›
  • News & Events
       

    News, Events and Classes

    • News
    • Events
    • Classes

     

    • Health Blog
    • Newsletter
    • How We Care Videos
    • For The Media
  • Giving
       

    Our Foundations

    • Providence Foundations of Oregon
    • Providence Benedictine Nursing Center Foundation
    • Providence Children's Health Foundation
    • Providence Community Health Foundation-Medford
    • Providence Hood River Memorial Hospital Foundation
    • Providence Milwaukie Foundation
    • Providence Newberg Health Foundation
    • Providence Portland Medical Foundation
    • Providence Seaside Hospital Foundation
    • Providence St. Vincent Medical Foundation
    • Providence Willamette Falls Medical Foundation

    Ways to Give

    • Ways to Give
    • Make a Donation
    • Gift Planning
    • Volunteer with Providence
  • Search
Share
Print this page
Email this page link to a friend
FaceBook
Tweet this
  • Home
  • Departments
  • Providence Behavioral Health
  • Forms
In this section
Providence Behavioral Health
Our Programs
Forms
Locations
Information
Contact Us

Behavioral Health Forms

Your behavioral health provider may ask you to fill out some forms before your appointment.

Choose the program or location to access the forms you might need for your visit:

  • Behavioral Health in Primary Care
  • Dialectical Behavior Outpatient Therapy Program
  • Neuropsychology Program
  • Adult Partial Hospitalization and Intensive Outpatient Program (PHP/IOP)
  • Adolescent Eating Disorder Program
  • Adult Eating Disorder Program
  • Substance Abuse Treatment Program
  • Pathway Program
  • Providence Hood River Memorial Hospital Behavioral Health
  • Providence Milwaukie Senior Psychiatry Clinic
  • Providence St. Vincent Child and Adolescent Clinic (West)
  • Providence Portland Psychiatry Clinic (East)
  • Providence St. Vincent Psychiatry Clinic (West)
  • Providence Willamette Falls Child and Adolescent Clinic
  • About Us
  • Clinician Resources
  • Health Plan
  • Providence Careers
  • Provider Careers
  • For Caregivers
  • MyChart

Patients & Visitors

  • Find a doctor
  • Find a hospital or clinic
  • Online doctor visits
  • Preregister for a hospital visit
  • Pay a bill
  • Billing information
  • Request financial assistance
  • Inquire about your medical records
  • Find employer and workplace services
  • Take a class
  • Send a gift to patient
  • Volunteer
  • Make a donation
  • Releasing a patient following a behavioral health crisis
  • Community benefit report
  • Capital project reporting
  • Help us improve health care
  • Providence careers
  • Physician and provider careers

Programs

  • Behavioral Health
  • Brain and Spine
  • Cancer
  • Children's Health
  • Diagnostic Imaging
  • Digestive Health
  • Employer and Workplace Services
  • Express Care
  • Heart and Vascular
  • Home Services
  • Orthopedics
  • Pregnancy, Labor and Birth
  • Providence Medical Group
  • Rehabilitation
  • Sports Medicine
  • Surgical Services
View All Services  ›

Locations

  • Hospitals and Medical Centers
  • ExpressCare Clinics
  • Immediate Care Clinics
  • Laboratory Service Clinics
  • Occupational Medicine Clinics
  • Physical Rehabilitation Clinics
  • Primary Care Clinics
  • Specialty Care Clinics
Search All Locations  ›

About Providence Health & Services

Providence Health & Services in Oregon is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and affiliated services guided by a Mission of caring that the Sisters of Providence began in the West nearly 160 years ago.

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

Our Core Values

Compassion, Dignity, Justice, Excellence, Integrity

Customer Service

  • Contact us

Providence Health Plan

503-574-7500 800-878-4445

Visit Our Other Websites

  • Providence Health Plan
  • Providence System Site

Patients & Visitors

  • Find a doctor
  • Find a hospital or clinic
  • Online doctor visits
  • Preregister for a hospital visit
  • Pay a bill
  • Billing information
  • Request financial assistance
  • Inquire about your medical records
  • Find employer and workplace services
  • Take a class
  • Send a gift to patient
  • Volunteer
  • Make a donation
  • Releasing a patient following a behavioral health crisis
  • Community benefit report
  • Capital project reporting
  • Help us improve health care
  • Providence careers
  • Physician and provider careers

Programs

  • Behavioral Health
  • Brain and Spine
  • Cancer
  • Children's Health
  • Diagnostic Imaging
  • Digestive Health
  • Employer and Workplace Services
  • Express Care
  • Heart and Vascular
  • Home Services
  • Orthopedics
  • Pregnancy, Labor and Birth
  • Providence Medical Group
  • Rehabilitation
  • Sports Medicine
  • Surgical Services
View All Services  ›

Locations

  • Hospitals and Medical Centers
  • ExpressCare Clinics
  • Immediate Care Clinics
  • Laboratory Service Clinics
  • Occupational Medicine Clinics
  • Physical Rehabilitation Clinics
  • Primary Care Clinics
  • Specialty Care Clinics
Search All Locations  ›

Find a doctor

Customer Service

  • Contact us

Providence Health Plan

503-574-7500 800-878-4445

Visit Our Other Websites

  • Providence Health Plan
  • Providence System Site
  • Our Services
  • Locations & Clinics
  • Find a Doctor
  • News & Events
FOLLOW US:
©2021 Providence Health & Services. All Rights Reserved.
Terms & Use of Privacy Policy | Disclaimer | Notice of Privacy Practice | Notice of Nondiscrimination and Accessibility Rights