Get a Form or Publication: mental health

Your search for "mental health" returned 8 documents.

Title Type Number
Application for Benefits - Crime Victims
Also available in: Spanish

Used by victims of a crime in Washington State to receive benefits for time lost from work, loss of financial support, medical or mental health treatment. The Spanish version of the instructions are online as F800-042-999.

Form F800-042-000
Application for Benefits- Crime Victims Spanish Instrucciones para: Solicitud para Beneficios para Víctimas de Crimen
Also available in: English

Instructions in Spanish to complete the English form F800-042-000 Application for Crime Victim benefits. The form is used by victims of a crime in Washington State to receive benefits for time lost from work, loss of financial support, medical or mental health treatment. This 12-10 version is internet only.

Form F800-042-999
Application to Reopen Claim - Spanish Aplicación para Reabrir un Reclamo Debido al Empeoramiento de la Condición
Also available in: English

Benefits are limited to $50,000 per claim. if your claim has met or exceeded this cap, your reopening application will be denied and we will be unable to pay any further benefits. Used by victims of crime and medical or mental health providers to request a claim be reopened.

Form F800-031-999
Application to Reopen Crime Victim Claim for Aggravation of Condition
Also available in: Spanish

Benefits are limited to $50,000 per claim. if your claim has met or exceeded this cap, your reopening application will be denied and we will be unable to pay any further benefits. Used by victims of crime and medical or mental health providers to request a claim be reopened.

Form F800-031-000
Mental Health Fee Schedule and Billing Guidelines

Manual: This manual is for providers who bill the Crime Victims Compensation Program for mental health services for crime victims.

Manual F800-105-000
Helping Providers Understand the Crime Victims Compensation Program

Fact sheet: Answers questions doctors and mental health counselors may have about the Crime Victims Compensation Program and billing for services. Also suggests steps these providers can take to speed up reimbursement.

Publication F800-102-000
Request for Survivor Counseling Benefits (English/Spanish)

Used by immediate family members of homicide victims to request mental health counseling.

Form F800-057-909
Statement for Crime Victims Mental Health Services

Used by the Crime Victims Compensation Program providers for reimbursement of Mental Health Services.

Form F800-025-000



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