Behavioral Health Quality Assurance Section: Forms

The Division of Behavioral Health is responsible for the publicly funded behavioral health continuum of care. We manage nearly 165 grants that fund behavioral health treatment and recovery services and programs across Alaska. Grantees are required to submit reporting on a quarterly basis to the Division for tracking outcomes and identifying successes as well as challenges within the grant funded programs. This page provides access to the report templates that grantees are required to use for their reporting. If you have questions about grant programs, please contact Community Mental Health Services Program Administer, Kathryn Chapman or 907-465-4959.

Fiscal Year 2023

FY23 Coversheets and Checklists

FY23 Quarterly Reports

Fiscal Year 2022

FY22 Coversheets and Checklists

FY22 Quarterly Reports

Fiscal Year 2021

FY21 Quarterly Reporting and Community Action Planning Instructions

FY21 Grant Coversheets and Reports


Adult Rural Peer Support - Grant Type 200

Ambulatory Withdrawal Management - Grant Type 239

ASAM Level 3.3 Residential SUD Services - Grant Type 257

Behavioral Health Provider's Association - Grant Type 202

Bethel Sobering Center - Grant Type 203

Bethel Community Service Patrol - Grant Type 203

Chemical Dependency Professional Certification - Grant Type 206

Comprehensive Behavioral Health Treatment and Recovery Outpatient- Grant Type 208

Comprehensive Behavioral Health Treatment and Recovery - SUD Residential - Withdrawal Management - Grant Type 208

Comprehensive Behavioral Health Treatment and Recovery - Peer and Consumer Services - Grant Type 208

Emergency COVID-19 for Mental Health and Substance Use Disorder- Grant Type 255

First Episode Psychosis - Grant Type 242

Independent Case Management - Grant Type 211

Parenting with Love and Limits (BTKH) - Grant Type 205

Permanent Supportive Housing - Grant Type 235

Permeant Supportive Housing - Projects for Assistance in Transition form Homelessness - PATH - Grant Type 235

Pregnant and Parenting Women Substance Use Disorder Services - Grant Type 252

Residential Care for Children and Youth - Grant Type 231

Residential Care for Children and Youth Training - Grant Type 230

Residential Substance Use Disorder Treatment Services - Grant Type 239

Rural Recovery Housing - Grant Type 256

Sobering Center Withdrawal Management Residential SUD - Grant Type 239

State Opioid Response (SOR) - Grant Types 247, 248, 249, and 250

Substance Use Disorder Expansion - Grant Type 239

Supported Employment - Grant Type 226

Therapeutic Court - Grant Type 227

Trauma Informed Behavioral Health Services - Grant Type 232

Designated Evaluation and Treatment Program

Substance Use Disorder Travel Assistance Forms

Medicaid Client Forms - Updated 12/5/2018

Non-Medicaid Client Forms - Updated 12/5/2018