Children from three through twenty years of age with QUEST or Medicaid fee-for-service
health insurance may be eligible to receive the highest levels of social and emotional
health services coordinated through CAMHD's team of mental health professionals. CAMHD's
eight Family Guidance Centers serve as the public's guide into the services delivery
system of assessments and services specifically designed to address the individual needs of the child and family.
A team of health and Department of Education professionals together with the parents
or guardians prepares a comprehensive service plan based on information gathered about the
child. A service plan may include: intensive case management; outpatient behavioral health
services; crisis residential services; intensive outpatient services; Multisystemic Therapy;
therapeutic foster home placement; community-based residential programs; and hospital-based
residential programs.
Available Materials
Brochure
Program Referral Process
Fill-In Forms
Download the forms below to your computer before using them. These forms can be printed out and
used as a hard copy on which to type or write, or they can be used as fill-in-the-blank
electronic forms on your computer. Completed forms including signatures and indicated
attachments should be faxed to the nearest CAMHD Family Guidance Center or to CAMHD's
QUEST Plan Assistant at 733-8375.
SEBD Referral Form
Consent to Evaluation/Treatment
Authorization for Use or Disclosure of Protected Health Information (PHI)
If you have any questions regarding these fill-in forms, please call (808) 733-9815 or
(808) 733-8372.
Family Guidance Centers
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