div class=trans-pagebuttonPage 1button div class=trans-image amp-img class=trans-thumb alt=Page 1: Psychiatric Behavioral Solutions - ViaQuestBehavioral Solutions STANDARD AUTHORIZATION FORM Fields marked with an asterisk * are required to be completed Failure to provide src=https:reader033fdocumentsinreader033viewer20220515116026d7ff41ccb02b9e03603chtml5thumbnails1jpg width=142 height=106 layout=responsive amp-img divpDate Rev 041119 • Page 3 of 3Date Rev 041119 • Page 3 of 3p pPsychiatric Behavioral Solutionspdiv