We will be adding forms to this page for the convenience of providers. Check back periodically for updates.

Individual and Group Outings Form

Monthly Residential Occupancy Report and Invoice Form and Instructions


To make it easier for Providers and NLCMHA employees to provide real time updates of vacancies within our 6-county catchment area, there is a special email address which is directed to our supervisors and other involved members of our agency who need to receive information on available vacancies. To report SRS Vacancies, send an email to which includes:

  1. the date vacancy is available
  2. the facility with the vacancy
  3. any comments you have regarding placement and to whom referrals should be directed.

Claims & Reimbursement Requirements

The newly revised Monthly Residential Occupancy Report and Invoice promotes legal compliance.  Michigan law requires every claim meet the standard of a “Clean Claim”. 

See  MCL 440.111i for the excerpt from the THE SOCIAL WELFARE ACT that defines this law.