Provider Resources

Download the Anne Arundel County Mental Health Agency Memorandum of Agreement (MOA) Form

View Current RFPs and RFIs from the Anne Arundel County Mental Health Agency

Download the Release of Medical Information Authorization Form

Before applying for licensure under Subtitle 10.63 - Community-Based Behavioral Health Programs and Services, behavioral health programs in Maryland must enter into an Agreement to Cooperate with the CSA, LAA, or LBHA in each of the relevant counties or Baltimore City in which the program operates. 

Download the Agreement to Cooperate Form and Instructions

Download the Application for Licensure under COMAR 10.63 for Community Based Behavioral Health Programs and Services.

Download the Residential Rehabilitation Program (RRP) Form from the Maryland Department of Health

Download the Fillable Form for Behavioral Health Care Coordination for Children and Youth/1915i

Download the Handwrtten Form for Behavioral Health Care Coordination for Children and Youth/1915i

Download the Maryland Health Administration Report of Death Form

Link to Access Behavioral Health Provider Forms from Carelon