Mental Health & Disability Services (MHDS)

Washington County Mental Health and Disability Services is a local access point for the Mental Health Agency of Southeast Iowa (MHASEI), a Mental Health and Disability Services Region serving the counties of Appanoose, Davis, Des Moines, Henry, Jefferson, Keokuk, Lee, Louisa, Mahaska, Monroe, Van Buren, Wapello, and Washington.

MHASEI Logo

Mission: Collaborate with people to provide welcoming integrated and individualized services that create opportunities to improve lives.

Vision: Facilitate open, quality and comprehensive services to adults, children and families with multiple issues in their lives. We strive to be welcoming, hopeful and helpful to people who have complex MHDS/CBH challenges, including trauma.

  1. Forms & Documents
  2. Providers
  3. Useful Links
  1. MHASEI MHDS Application for Adults
  2. MHASEI MHDS Application Cover Page for Adults
  3. MHASEI MHDS Application for Children
  4. MHASEI MHDS Application Cover Page for Children
  5. MHASEI MHDS Notice of Privacy Practice
  6. MHASEI Acknowledgment of Receipt of Notice of Privacy Practice for Providers and HIPAA Covered Entities
  7. MHASEI Request for Service Funding
  1. MHASEI Residency Determination Worksheet
  2. MHASEI Change of Information Form
  3. MHASEI Appeal Process
  4. MHASEI Authorization to Obtain and/or Disclose Information
  5. CSN Authorization
  6. MHASEI Brochure
  7. MH Resource Guide for the Community