Community Multidisciplinary Team (MDT)

Child/Youth Information:


Is it okay to leave a voicemail at this number?
YesNo

*REQUIRED


Insurance Provider:
Medicaid

Commercial

None


I would like to consult with the Team About:
Outpatient Service Navigation: I am looking for recommendations regarding outpatient mental health and/or substance use disorder treatment resources.
Care Coordination Needs: I am looking for assistance with care coordination for a youth enrolled in various services or multiple system involvement (Juvenile Justice, Behavioral Health, Foster Care, etc.)
Behavior Management Strategies: I am looking for recommendations for behavioral management strategies to support safety within the community
Transitional Planning: I have a child/client who is transitioning back into the community from placement (inpatient unit, CLIP) who needs additional supports or recommendations for transitioning back into the community
Discharge Planning: I need assistance with developing a discharge plan from an Emergency Department
Family Engagement Ideas: I need assistance with engaging a family in services or to address barriers in access to services
Safety Planning: I am a provider who would like consultation to complete a safety plan
Other:


Referent Information:





*REQUIRED


To maintain the privacy of youth and family a release of information (ROI) is required. A Release of Information is required to be signed by youth over the age of 13. Do you currently have a signed Release of Information (ROI)?
YesNo

If you don’t have access to a Release of Information (ROI) you can use this form


How did you hear about Kids’ Mental Health Pierce County?
A Friend or Family MemberA ProviderOnline SearchSocial MediaFlyer/PrintOther

If you have additional questions please contact Ashley Mangum at 253-403-1363 or amangum@multicare.org

“There is nothing more important than addressing the mental health needs of children and families. This is how we change the trajectory for better health outcomes later in life and create equity and access within our systems.”

Joe Le Roy
President & CEO HopeSparks