Treatment Services and Vendor Forms

Authorization to Release Conf. Info Drug Abuse Programs
PROB 11B

Authorization to Release Conf. Info MH Program
PROB 11I

Authorization to Release Conf. Info SA & MH Programs
PROB 11E

Breathalyzer Log (Client)
TSS 6

Daily Travel Log
PROB 17

Daily Treatment Log
TSS 7

Form Required for Staff Addition
TSS 8

Monthly Treatment Report (Co-Occuring Residential)
PROB 46-CO-RES

Monthly Treatment Report (MH Case Management)
PROB 46-MHCM

Monthly Treatment Report (Outpatient Mental Health)
PROB 46-MHO

Monthly Treatment Report (Outpatient Substance Abuse)
PROB 46-SAO

Monthly Treatment Report (Residential Substance Abuse)
PROB 46-SA-RES

Monthly Treatment Report (Sex Offender Treatment)
PROB 46-SO

Sample Violation Report for Vendor (Mental Health)
TSS 9-MH

Sample Violation Report for Vendor (Substance Abuse)
TSS 9-SA

Sweat Patch Testing Log (Client)
TSS 10

Transportation Authorization Form
TSS 11

Treatment Plan
TSS 15

Treatment Services Invoice
TSS 12

Urinalysis Log (Client)
TSS 13

Vendor Supply Order Form
TSS 14
Last Updated:
04/16/2018