Provider Forms HIPAA/Privacy Practice Notice Trifold GOSH Billing Authorization Disclosure GOSH Enrollment Form Richland CAP GOSH Residency Verification Form (RVF) GOSH Staff Disclosure of Information Benefits Plan Brochure Comprehensive Richland CAP Approval SFY2026 Intent to Purchase DocumentsIf you need an emailed version of this form please contact Sherry Branham at 419-774-5811. Please Read First: Application Process for SFY2026 Funding Application Instructions for FY2026 Detail Program Description for FY2026 Budget Requirements for FY2026 Marijuana Attestation RCMHRS Marijuana Attestation Agency Agreement FY2026 MHA UCR FY2026 Service Projection Form Template FY2026 MHA 052 Certificate Regarding Debarment, Suspension and Other Responsibility Matters Primary Covered Transactions Benefit Plan Brochure FY2026 Request for Funding Application Checklist
