Forms

Communication Authorization Forms

Alcohol & Drug Treatment Facility or Mental Health Center	Birchwood Solutions	Credentialing Agency
Employer	Evaluator or Health Care Provider	Inspector General
Miscellaneous	Sponsor	Tennessee Department of Health

Other Forms

Therapist Report/ ASAM Level I Report	Employer Evaluation	Request for Services
Meeting Attendance Verification	Records Request	Student Nurse Evaluation Form
Referral Form	Verification of Prescribed Medication