Department of Mental Health and Addiction Services

State of Connecticut

Official Website: https://portal.ct.gov/DMHAS

The Connecticut Department of Mental Health and Addiction Services is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-sufficiency in those they serve.

Forms & Documents

Browse all Department of Mental Health and Addiction Services government forms

21 - 37 of 37 forms

Form Title Topics
First Report of Injury (WC207)
FMLA REQUEST INTAKE FORM
IMPORTANT! THIS APPLICATION MUST BE SUBMITTED TWO WEEKS PRIOR TO THE BEGINNING OF THE COURSE(S) TO YOUR AGENCY APPROVAL OFFICER
Individual Application for State In-Service Training Program
Manager Sick Leave Bank (MSLB) - Application for Use
Mileage Worksheet for Medical Treatment
RELEASE OF PERSONNEL/PAYROLL AND EDUCATIONAL INFORMATION
Request for Unpaid Leave (Less than 5 Days)
Request for Use of Accrued Leave with Worker's Compensation (WC715)
State of Connecticut Human Resources Dual Employment Request Form
State of Connecticut Human Resources Employee Request For Family and Medical Leave Entitlements
State of Connecticut Human Resources Medical Certificate
Temporary Service in Higher Class (TSHC) Request Form
TRAVEL AUTHORIZATION REQUEST
TRAVEL AUTHORIZATION REQUEST
Verification of Medical Appointment
Voluntary Schedule Reduction Program (VSRP) (CT-HR-7c)

Contact Information & Office Locations

1 contact point

Main Office

Address:
PO Box 341431
410 Capitol Avenue
Hartford, CT 06134

Phone numbers:
  • (860) 418-7000
  • (860) 418-6974 (Deaf/Deaf-Blind/Hard of Hearing)
  • (888) 621-3551 (TDY , Toll Free in Connecticut)
Hours of operation:
  • Most DMHAS facilities and programs are open daily from 8am to 4:30pm, however some DMHAS facilities offer expanded access (assessment & intake) and intensive programs that extend beyond those hours.

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