Department of Behavioral Health - Fresno County - co fresno ca 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Agency Name and Date in the designated fields at the top of the form.
3. In the 'Proposed Cost' section, fill in the costs for each service type, including Day Treatment and Case Management. Ensure you specify both full-day and half-day rates as applicable.
4. Complete the 'Applicant Information' section by providing your Contact Name and Telephone number. Check all applicable boxes under 'Application Filed By'.
5. Fill out the Program Information section, including Program Name and addresses. Make sure to print your Signatory Name and Title before signing and dating the application.
6. Review all entries for accuracy before saving or exporting your completed application from our platform.

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