Behavioral Care Forms

Click here to read Prevea Health Notice of Privacy Practice.

Green Bay Area

If you have questions, call Prevea Behavioral Care (920) 272-1200.

Patients under age 18 - click to download
Patients 18 and older - click to download

Sheboygan Area

If you have questions, call Prevea Behavioral Care at (920) 458-5557.

Patients under age 18 - click to download
Patients 18 and older - click to download

Save and upload or take pictures of all completed forms, and send to Prevea Behavioral Care’s confidential e-mail: bcforms@prevea.com.

Please include the location of your appointment in the subject line.

School Based Mental Health

If you have questions, call Prevea Behavioral Care (920) 272-1200.

School Based Mental Health Forms - click to download

If financial assistance is needed, please complete and send this form or call (920) 405-1445 with questions.

Save and upload or take pictures of all completed forms, and send to Prevea Behavioral Care’s confidential e-mail: bcforms@prevea.com.

Please include "School Based Mental Health" in the subject line.