We provide high quality psychiatric and clinical services to our community.
Bio-Behavioral Medical Clinics, Inc.
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Provider Info
- Psychiatrist
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USING THE FORMS
To utilize our forms, you will need Adobe Acrobat®. Press the icon to acquire.
Provider Information (Mental Health Therapist)

The information below is to assist mental health therapists with patient authorizations and requests for additional services. If you have any questions, don't hesitate to call our office at 559/437-1111 for clarification.

1. Information on securing authorizations for Medicare patients within Sante IPA

Below are four (4) options for using the authorization form, so completing and processing will be easier than ever.

2. Therapist Request for Additional Treatment (Form for use with Sante IPA patients.)

a. Therapist Request for Additional Treatment. Download to desktop, complete using Adobe Acrobat® or your .pdf reader, PRINT. When completed, please FAX back to BBMC at 559/437-1118.
or
b. Therapist Request for Additional Treatment. Download .pdf file, PRINT, complete by hand. When completed, please FAX back to BBMC at 559/437-1118.
or
c. Therapist Request for Additional Treatment. This is a Microsoft Word® Template (.dotx) file to store in your computer's "User Defined Templates" file. It will always be ready to open and complete in Word®. When completed, please FAX back to BBMC at 559/437-1118.
or
d. Therapist Request for Additional Treatment. This is a Microsoft Word® file (.docx); download and complete in Word. You can keep a copy handy or come back any time for another. When completed, please FAX back to BBMC at 559/437-1118.
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