Intake | Federal Injury Behavioral Health | OWCP Behavioral Health Services

OWCP BEHAVIORAL HEALTH SERVICES INTAKE REQUEST

This intake request is for current or former federal employees seeking psychological services related to an active or pending Federal Workers’ Compensation (OWCP) claim.

This is not a general therapy intake. Submission does not guarantee acceptance into services.

Name *

Date of Birth *

Preferred Phone Number *

Email address *

Preferred Contact Method *

Phone
Email

State of Residence *

GEORGIA
FLORIDA

Federal Agency / Department *

Job Title / Role at Time of Injury *

Date of Work-Related Injury or Event *

Claim Status *

Pending
Accepted
Previously denied
Unsure

OWCP Claim Number (if available)

Briefly describe the work-related psychological concerns for which you are seeking services.

Care Model Acknowledgment

Federal Injury Behavioral Health (FIBHC) provides behavioral health services exclusively for individuals with active or pending Office of Workers’ Compensation Programs (OWCP) claims.

Services are delivered through a structured, team-based clinical model. Patients are assigned to licensed clinicians based on licensure, clinical needs, availability, and continuity of care. Provider selection is not part of the intake process, and a patient’s assigned clinician may change as part of coordinated care.

Services are provided by telehealth and are limited to behavioral health treatment related to the OWCP claim. FIBHC does not provide legal advice or guarantee claim outcomes. All clinical documentation is completed in accordance with applicable professional standards, governing law, and OWCP requirements.

I acknowledge *

I have read, understand, and agree to the FIBHC care model described above.

What happens next?

Your request will be reviewed for eligibility and clinical availability.
If your request meets FIBHC intake criteria, a member of our team will contact you.
If accepted, you will receive instructions to complete your secure patient intake through our electronic health record before scheduling.