Provider Forms and Links

Kepro:

Kepro Forms and Instructions can be found at www.qualitycareforme.com

Kepro Provider Relations can answer questions at 1-866-521-0027, Option 1 or via email at providerrelationsme@kepro.com

Adolescent Residential Rehabilitation Performance Measures Report:

• Access the Adolescent Residential Rehabilitation Performance Measures Report (Microsoft Forms)

Parent Coaching Performance Measures Report

• Access the Parent Coaching Performance Measures Report (Microsoft Forms)

Enterprise Information System (EIS): You must use Chrome as your browser for these links, Internet Explorer no longer works

• EIS

Rehabilitative and Community Services (RCS) (MaineCare Section 28):

• Comprehensive Assessment: Guide to Conversation
• Application to provide Specialized RCS28

Individual Planning Funds (IPF):

• Form (Word)
• Parent/Guardian Liability/Acknowledgment Form (Word)

Children's Residential Care Facility (CRCF):

• CRCF information and documents

Co-Occurring Disorders (Mental Health, Trauma-Related Mental Health and Substance Use Disorders)

• AC-OK COD Adolescent Screening Tool (PDF)
• AC-OK COD Adult Screening Tool (PDF)