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2026 Behavioral Health Conference — Sponsorship Application

Department
Health Services
Document Type
Application
Application form to become a sponsor for the 2026 Area Wide Tribal Behavioral Health Conference.
Sponsorship Application - 2026.pdf
  • Read more about 2026 Behavioral Health Conference — Sponsorship Application

2026 Behavioral Health Conference — Sponsorship Opportunities

Department
Health Services
Document Type
Resource Guide
Sponsorship opportunities and levels for the 2026 Area Wide Tribal Behavioral Health Conference.
Sponsorship Opportunities - 2026.pdf
  • Read more about 2026 Behavioral Health Conference — Sponsorship Opportunities

2026 Area Wide Tribal Behavioral Health Conference — Agenda

Department
Health Services
Document Type
Resource Guide
Draft agenda for the October 6-7, 2026 Area Wide Tribal Behavioral Health Conference.
Draft Agenda 2026.pdf
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Confidential Patient/Client Complaint Form

Department
Health Services
Document Type
Form
Submit a confidential complaint about health services received.
ConfidentialPatientClientComplaint.pdf
  • Read more about Confidential Patient/Client Complaint Form

Prescryptive Member Reimbursement Form

Department
Health Services
Document Type
Form
Form to request reimbursement for pharmacy expenses through Prescryptive.
prescryptive-Member-Reimbursement-Form.pdf
  • Read more about Prescryptive Member Reimbursement Form

Financial Agreement for Registration

Department
Health Services
Document Type
Form
Financial agreement form required during patient registration.
Financial-Agreement-for-Registration-2023.pdf
  • Read more about Financial Agreement for Registration

Release of Information (General)

Department
Health Services
Document Type
Form
General authorization to release protected health information.
https://www.cowlitz.org/sites/default/files/2026-02/ROI%202.4.26.pdf
  • Read more about Release of Information (General)

Release of Information (42 CFR TPO)

Department
Health Services
Document Type
Form
Authorization for release of health information for treatment, payment, and operations.
https://www.cowlitz.org/sites/default/files/2026-02/ROI%2042%20CFR%20TPO%202.17…
  • Read more about Release of Information (42 CFR TPO)

Patient Rights and Responsibilities

Department
Health Services
Document Type
Policy
Statement of patient rights and responsibilities for Cowlitz health services.
2023PatientRightsandResponsibilities.pdf
  • Read more about Patient Rights and Responsibilities

Notice of Privacy Practices

Department
Health Services
Document Type
Policy
Notice of privacy practices for health information under HIPAA.
https://www.cowlitz.org/sites/default/files/2026-02/NPP%202.17.26.pdf
  • Read more about Notice of Privacy Practices

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Cowlitz Indian Tribe

1055 9th Ave, Longview, WA 98632
Phone: (360) 577-8140 
Hours: Monday-Friday, 8:00am to 5:00pm

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