Behavioral Health
Provider Forms and Help Sheets
- Provider Network & Contracting Department Help Sheets
- Providers or Groups Requesting to Contract with AZPC
- Forms for Existing Groups Contracted with AZPC
- Existing Practice Group Participation Request Form
- Physician Assistant Delegation of Services Agreement
- Provider/Physician Roster – Fillable PDF
- Provider/Physician Roster – Spreadsheet Version
- Ancillary Facility Application
- Provider/Group Update Form
- Demographic Update Form
- Individual Provider Termination Form
- Group Termination Request Form
- Compliance Forms