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The forms below are PDF publications
that can be downloaded and printed from the
Internet. To view or print PDF files, Adobe Acrobat
Reader must be installed on your computer.
The Division of Behavioral Health Services Forms:
Physician
Certification of Adult With A Serious Mental Illness
and
Physician Certification of Children With Serious
Emotional Disturbance are available.
If you need this material in a different format,
such as large print, contact our Americans with
Disabilities Act Coordinator at 682-6789 or
1-877-708-8191. Both telephone numbers are voice and
TDD.
The Arkansas Department of Human Services is in
compliance with Titles VI and VII of the Civil
Rights Act and is operated, managed and delivers
services without regard to religion, disability,
political affiliation, veteran status, age, race,
color or national origin.
CONTACT INFORMATION:
Policy and Certification Office
Division of Behavioral Health Services
Administration Building
305 South Palm Street
Little Rock, Arkansas 72205
Telephone: (501) 683-6903
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