SUD Referral Sources Information
Forms for Referral Sources
To refer clients into substance use disorder treatment services funded by the State of Idaho, please see the documents listed below.
To help clients choose a provider, search for Treatment & Recovery Support Services providers here.
To help clients funded by the Idaho Department of Juvenile Corrections choose a provider, use the IDJC provider search here.
Questions? Contact BPA Health at 800-922-3406.
Mental Health Court Funding Profile (SUD) Updated February 14, 2023
See Funding Profile Instructions for additional information, by clicking the download button to the right.
Authorization for Use and Disclosure Form Updated February 7, 2023
Authorization for use and disclosure to release information to approved agency/entity. Referral sources should include this form with the Funding Profile Form.
Click the download button to the right.
Click the download button to the right.
IDHW General Release of Information Form Updated February 14, 2023
Release of information form for Idaho substance abuse treatment and recovery support services.
Click the download button to the right.
Click the download button to the right.
General Release of Information Form Updated February 14, 2023
General form for consent to release and exchange information.
Click the download button to the right or Click Here.
Click the download button to the right or Click Here.