1-888-322-2136info@kbhmaine.org DONATE ABOUT US SERVICES CAREERS OUR NEWS RESOURCES GIVE CONTACT RESOURCES Referral forms for individuals and providers Home Resources For general referrals (not from Maine DHHS or Department of Corrections employees) Primary Care Physician Referral Form (note: we have expanded our web-based referral capacities that results now in the fastest way to submit a referral. Please email Amanda Fitts for more information or to register.) Central Access Form Orientation Manual Nondiscrimination & Accessibility Statement Orientation Intake Consent for Treatment HIPAA Consent for Purposes of Treatment Multisystemic Therapy Referral Screening Form Notice of Privacy Practices Children’s Home and Community-Based Treatment Referral Form Release-of-Information Forms Waterville 11 Caldwell Rd., Augusta 66 Stone St., Augusta Winthrop Skowhegan For Maine DHHS referrals only: Consider entering your referral directly online in our secure Access entry system. For more information about this confidential site and to register, please contact Amanda Fitts at afitts@kbhmaine.org. DHHS Office of Child and Family Services Referral Checklist Please refer to downloadable documents above for Orientation Manual Intake Consent HIPAA Consent Release of Information Notice of Privacy Practices Multisystemic Therapy Referral For Maine Dept. of Corrections referrals only: Consider entering your referral directly online in our secure Access entry system. For more information about this confidential site and to register, please contact Amanda Fitts at afitts@kbhmaine.org. Department of Corrections (DOC) Referral Checklist Please refer to downloadable documents above for Central Access Form Orientation Manual Intake Consent HIPAA Consent Release of Information Notice of Privacy Practices Multisystemic Therapy Referral Complaint Instructions/Grievance Form Standards of Conduct/ Corporate Compliance BPAP Housing Application Form Shelter Care Plus Application Form Request for Recovery Coach Services: ABOUT US Kennebec Behavioral Health’s mission is to promote the well-being of persons who experience mental illness, emotional difficulties or behavioral challenges. We are a community-based mental health provider with locations throughout central Maine. USEFUL LINKS PRIVACY POLICY MAINE RELAY: 711 CLIENT PORTAL EMPLOYEE PORTAL RECENT POSTS Village Clubhouse Passes Clubhouse International Accreditation November 9, 2021 KBH Ranks 10th in Best Places to Work (Large Companies) October 22, 2021 JOIN OUR NEWSLETTER Email Address SUBSCRIBE Job Opportunities Services Contact Give 2021 © Kennebec Behavioral Health