Michigan Behavioral Health Standard Consent Form

Please click the link below to fill out an electronic copy of the Michigan Behavioral Health Standard Consent Form (MDHHS-5515). Filling this out can help NorthCare Network share your protected health information with your providers to help make sure you get the care you need when you need it. If you need help filling out this form, please call (800) 305-6564 or (906) 225-7222.

Michigan Behavioral Health Standard Consent Form (MDHHS-5515)

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