Forms & Documents By Category


Contract Renewal Documents  

Standard Documents for FY 24-25
  • Exhibit A - Attachments
    • Exhibit A: Table of Contents (Template)
    • Exhibit A-1: Standard Requirements for Mental Health (MH) Contracts
    • Exhibit A-1: Standard Requirements for Substance Use Disorder (SUD) Contracts
    • Exhibit A-2: CBO Lobbying Restrictions & Disclosure Certification (Master Contracts Only - See Exhibit G for Services-As-Needed Contracts)
      • Attachment 1: Certification Regarding Lobbying – Certification form
      • Attachment 2: Certification Regarding Lobbying – Disclosure form
    • Exhibit A-3: SUD Qualified Service Organization Agreement (Master Contracts Only - See Exhibit H for Services-As-Needed Contracts)
  • Exhibit A – Program Requirements/Scopes of Work (Exhibit A-P/SOWs) for Substance Use Disorder Contracts

Standard Documents for FY 23-24
  • Exhibit A – Program Requirements (Exhibit A-P/SOWs) for Substance Use Disorder (SUD) Contracts

Standard Exhibit and Reference Only

Mental Health  

Housing/Homeless Criteria and Definition of Terms
EveryOne Home Alameda County Continuum of Care (CoC) Council Prioritization for Permanent Supportive Housing Opportunities

Shift of Funds Request Family Engagement and Group Services Reminder

Provider Resources  

MHP FFS Provider Forms  

  • MHP FFS Provider Handbook
  • Provider Update Form (Form No. 50-02) – Use this form to updated BHCS of changes such as:
    • your location/address
    • email, phone, or fax
    • name
    • a change to status with any licensing/oversight board that may impact your ability to provide, claim or be reimbursed for specialty mental health services
  • Voluntary Disenrollment Form (Form No. 50-03) – Use this form to voluntarily dis-enroll from the MHP Provider Network
  • FAQs

Substance Use Disorder  

Coming soon



Organizational and/or Program Changes Forms
Other Standard Forms