Please complete the form below to notify CuraLinc Healthcare of a new Delta TeamCare Behavioral Health client. Your CuraLinc Client Relationship Manager will send a confirmation of receipt within two business days.

This is necessary for clients to access the TeamCare BH website
Program Effective Date *
Program Effective Date
Client Address
Client Address
Client Contact Name
Client Contact Name
Client Contact Phone Number
Client Contact Phone Number
Delta Contact Name *
Delta Contact Name
Delta Contact Phone Number
Delta Contact Phone Number
Broker Contact Name
Broker Contact Name
(if applicable)
Broker Contact Phone
Broker Contact Phone
Plan Design (Session Model) *
Does the company have a UR vendor? If so, who is the provider?
Does the company have a Disease Management vendor? If so, who is the vendor?
Does the company administer a Health Risk Assessment Test? If so, who is the provider?
Does the company provide mental health and substance abuse (MHSA) benefits? If so, what is the company's MHSA network(s)?
Is TeamCare BH Listed on the Insurance Card as an Entry Point for MH/SA?

Note: In addition to short-term counseling, all Delta TeamCare Behavioral Health models include free legal and financial consultation, expert dependent care referrals, organizational consultation, video counseling and a technology suite (web platform and mobile app) that can be tailored at a group, client or partner level. All programs also include access to worksite service components, such as critical incident response services and training.