Authorization Request for
New Inpatient Mental Health Service
Click here to open and print or save the Authorization Request for New Inpatient Mental Health Service form.
This request is to only be used for NEW INPATIENT MENTAL HEALTH SERVICES for a client. To request additional inpatient services, please complete the "Authorization Request for Additional 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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