Authorizations & Referrals
Provider Directory To view the location, demographic, and other information you have on file with NDBH, please search your name in the Provider Directory. Access Provider Directory >
Forms Authorization For Use And Disclosure Of Health Information (Release of Information) Authorization For Use And Disclosure Of Health Information (Instructions) Provider Information for Authorization Form (PIA) Medical Referral Form/FEP Blue Cross Blue Shield Michigan to NDBH Medical Referral Form/MI Employee Group Blue Cross Blue Shield Michigan to NDBH Transcranial Magnetic Stimulation Treatment Request Form