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    • Home
    • (PBH Clinicians Only)
      • Submit Request / Question
      • Psychiatric Med Referral
      • PBH Credentialing Guide
      • Supervisors
      • PBH Payments
      • Private vs County Pay
      • Tutorials and PDFs
      • Testing
      • FAQ
      • Carelon Calendar Update

Signed in as:

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  • Home
  • (PBH Clinicians Only)
    • Submit Request / Question
    • Psychiatric Med Referral
    • PBH Credentialing Guide
    • Supervisors
    • PBH Payments
    • Private vs County Pay
    • Tutorials and PDFs
    • Testing
    • FAQ
    • Carelon Calendar Update

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Tutorials and PDFs


 

PBH Downloadable Consent Forms (1 of 2)

(PBH) Arbitration Agreement (pdf)Download
(PBH) Blue Cross and Blue Shield (pdf)Download
(PBH) Consent for Telehealth Consultation (pdf)Download
(PBH) COVID-19 and Variants Liability Release Waiver (pdf)Download
(PBH) Credit Card Automatic Charges (pdf)Download
(PBH) Dispute Charges (pdf)Download
(PBH) Form Completion Policy (pdf)Download
(PBH) Individual Intake Questionnaire (pdf)Download
(PBH) Informed Consent for Treatment (pdf)Download
(PBH) Insurance Information (pdf)Download
(PBH) Minor Consent for Treatment (pdf)Download
(PBH) Notice of Privacy Practices (pdf)Download
(PBH) PBH Inc. Billing Service (pdf)Download
(PBH) Please upload your insurance card (pdf)Download
(PBH) Practice Policies (pdf)Download

PBH Downloadable Consent Forms (2 of 2)

(PBH) Psychological and Headway Billing Service (pdf)Download
(PBH) PSYCHOTHERAPY CLIENTS (pdf)Download
(PBH) Upload documents and insurance card (pdf)Download

PBH Downloadable Consent Forms (Spanish)

(Spanish) Acuerdo de Arbitraje (pdf)Download
(Spanish) Acuerdo de copago y deducible del seguro (pdf)Download
(Spanish) Anthem Blue Cross and Blue Shield_Spanish (pdf)Download
(Spanish) Aviso de prácticas de privacidad (pdf)Download
(Spanish) CONSENTIMIENTO - MENOR (pdf)Download
(Spanish) CONSENTIMIENTO DE TELESALUD (pdf)Download
(Spanish) Consentimiento fundamentado para psicoterapia (pdf)Download
(Spanish) Consentimiento para telesalud (pdf)Download
(Spanish) Cuestionario de Salud (pdf)Download
(Spanish) Información del seguro (pdf)Download
(Spanish) Servicio de facturación de PBH (pdf)Download
(Spanish) Subir documentos y tarjeta de seguro (pdf)Download
(Spanish) COVID (pdf)Download

Kaiser Downloadable Forms

External Provider Handbook 2021 (pdf)Download
Set up Lucet Account (pdf)Download
CALM Handout (pdf)Download
Couples Therapy One Sheet (pdf)Download
External Provider Scheduling and Documentation Refresher (pdf)Download
Ginger Handout (pdf)Download
KP Branded Center for Healthy Living (pdf)Download
KP Branded Regional Mental Wellness (pdf)Download
KP Neuropsych External providers (pdf)Download
KP OSM information on FIC and TPI (pdf)Download
KPEP Couples counseling Referral_2021 (pdf)Download
KPEP Group Referral_2021 (pdf)Download
KPEP Medication Evaluation Referral_2021 (pdf)Download
Mystrength handout (pdf)Download

Videos (Kaiser)

Hello
Lucet Training Videos

Private vs Ventura and LA County Earnings

Private Practice vs Ventura County vs LA County Earnings (pdf)Download

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