Authorization Request for
Additional Inpatient Mental Health Services
Click here to open and print or save the Authorization Request for Additional Inpatient Mental Health Services form.
This request is to only be used for ADDITIONAL INPATIENT MENTAL HEALTH SERVICES for a client. To request new inpatient services, please complete the "Authorization Request for New Inpatient Services" form found at www.team-mn.com.
Please print clearly. Incomplete or illegible forms can not be processed.
Please fax completed forms to TEAM at: 651-642-1809
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