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(480) 590-6558

Referrals

Alliance Behavioral Care provides services to individuals from a wide variety of backgrounds and geographical locations. Currently we are contracted with all Regional Behavioral Health Authorities (RBHAs) and Health Plans in Arizona.

Eligibility is determined after a face-to-face assessment takes place and through mutual agreement between the referral source, the individual being referred, and Alliance Behavioral Care. Upon receipt of a referral, a member of the Alliance Behavioral Care’s clinical team will conduct a face-to-face, individualized assessment of the individual.

If an individual is accepted into our program the following items are required upon admission or prior:

  • Face Sheet with correct contact information- PCP, Payee, Advocate, Parents, Guardian, etc.
  • AHCCCS Eligibility Verification- copy of card or printout
  • Physical/Nursing Assessment- must be dated within seven days of admission
  • TB Test- conducted within the last six months with negative results
  • Part D/ISP- Must have current signatures and be less than six months old
  • Part E/Comprehensive Assessment- Must have current signatures and be less than six months old
  • Current Medications/Doctors Orders/Written Prescriptions
  • Current At Risk Crises Plan- if applicable
  • Copy of Court Ordered Treatment- if applicable
  • Copy of Guardianship Documentation- if applicable
  • Copy of Probation and Parole Documentation- if applicable
  • Copy of Conditional Release Documentation- if applicable
  • Copy of Payee Documentation and Contact Information- if applicable