Department of Mental Health and Addiction Services

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

1 - 20 of 37 forms

Form Title Topics
2017 Employee's Withholding Certificate
Accident Investigation Report (WC207-1)
Alternate Work Schedule (A&R Employees)
APPLICATION FOR REFUND RETIREE HEALTH CONTRIBUTIONS
Career Mobility: Application (1199) Bargaining Union only
CAREER MOBILITY GUIDELINES, SUMMER 2020
Certification Assistance Fund, Fiscal Year 2020 (July 1, 2019 – June 30, 2020)
Concurrent Employment Third Party Liability Form (WC211)
DEPARTMENT OF MENTAL HEALTH & ADDICTION SERVICES Affirmative Action Grievance Form
DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES REASONABLE ACCOMMODATION REQUEST FORM REQUEST FOR REASONABLE ACCOMMODATION UNDER THE AMERICANS WITH DISABILITIES ACT
DESIGNATION OF RETIREMENT PLAN ELECTION Non-Higher Education Employment Only
DESIGNATION OF RETIREMENT PLAN ELECTION Non-Higher Education Employment Only
DIRECT DEPOSIT AUTHORIZATION AND INPUT FORM
Duties Questionnaire Form
Emergency Contact
EMPLOYEE PAYROLL REIMBURSEMENTSFOR EXPENSES INCURRED IN THE SERVICE OF THE STATE OF CONNECTICUT
EMPLOYEE PAYROLL REIMBURSEMENTSFOR EXPENSES INCURRED IN THE SERVICE OF THE STATE OF CONNECTICUT
ENROLLMENT FOR PARTICIPATION IN THE MANAGEMENT SICK LEAVE BANK
Federal Tax (W-4) 2017
Filing Status & Exemption (1A)

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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