Behavioral Health

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Behavioral Health Forms

DD Form 2870, Authorization For Disclosure of Medical or Dental Record
DD Form 2870, Authorization For Disclosure of Medical or Dental Record: This form is to provide the Military Treatment Facility/Dental Treatment Facility/TRICARE Health Plan with a means to request the use and/or disclosure of an individual's protected health information.

Download Form
DD Form 2005 Privacy Act Statement
DD Form 2005, Privacy Act Statement requires patient acknowledgement of Privacy Act practices.

Download Form
Telehealth Consent Form
Telehealth Consent Form provides authorization to receive or record telehealth services.

Download Form

Contact Us

Hours

Mon - Fri: 7:30 a.m. - 4:30 p.m.

Triage and Walk-in

Mon - Wed: 7:30 a.m. - 3:30 p.m.
Thu: 9:00 a.m. - 3:30 p.m.

** Times may have changed due to COVID-19. Check out Local COVID-19 Response for more information.

Telephone Number

520-533-5161

Location

2240 E. Winrow Ave.
Ft. Huachuca, AZ 85613

Mental Health Resources

Veterans Crisis Line

CONUS:
NORTHCOM
988, Press 1
Text 838255

OCONUS:
INDO-PACIFIC
+1-844-702-5493 or DSN 988
EUCOM
+1-844-702-5495 or DSN 988
CENTCOM
+1-855-422-7719 or DSN 988
AFRICOM
+1-888-482-6054 or DSN 988
SOUTHCOM
+1-866-989-9599 or DSN 988

Open to all service members and veterans, even if not enrolled in VA benefits or health care. Long distance or overseas charges may apply. Learn More

Military Crisis Line

Call: 988 and press 1
Text: 838255

Military OneSource

Call 800-342-9647

InTransition Program

Call 800-424-7877

Email
Live Chat

Psychological Health Resource Center | 24/7

Call 866-966-1020

Patient Resources