Join Behavioral Health Alliance of Montana

New Member Registration Form

Please use the form below to provide us with your information. Once approved for membership, you can mail a check to: Behavioral Health Alliance of Montana, P. O. Box 7635, Missoula, MT 59807

Organization Address(Required)
Our Organization Provides Mental Health Services(Required)
(Check all that apply)
Our Organization Provides Addiction Services(Required)
(Check all that apply)
Populations Served(Required)
(Check all that apply)
$ [FY budget] X 0.1% (.001) = $ [FY BHAM Dues] // min $1250, max $20,000