Pec form louisiana 2026

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The document outlines the certification process for organizations seeking to become providers under the Louisiana Behavioral Health Partnership (LBHP). It details the requirements for organizational certification, including compliance with the Office of Behavioral Health (OBH) standards, submission of necessary documentation, and adherence to specific service definitions. The document also includes legal disclaimers regarding the accuracy of information and emphasizes the importance of maintaining compliance with all operational requirements. Additionally, it provides instructions for completing the LBHP Certification Application and highlights the responsibilities of both applicants and the OBH Certification Section.

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Click ‘Get Form’ to open the PEC Form Louisiana in the editor.
Begin by filling out the Basic Applicant Information section. Enter your organization name, primary contact person, and address details accurately.
In Section Two, if applicable, provide details regarding LBHP Curricula Approval. Ensure you attach any necessary documentation that supports your application.
Complete Section Three by listing all organizational staff members. Include their names, educational levels, and the types of services they provide.
Proceed to Section Four and check off each attestation statement to confirm compliance with all requirements outlined in the LBHP Service Definition Manual.
Finally, sign and date the Attestation Statement in Section Five to affirm that all information provided is accurate and complete.

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