Treatment Services and Vendor Forms

Authorization to Release Conf. Info Drug Abuse Programs

PROB 11B

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Authorization to Release Conf. Info MH Program

PROB 11I

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Authorization to Release Conf. Info SA & MH Programs

PROB 11E

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Breathalyzer Log (Client)

TSS 6

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Daily Travel Log

PROB 17

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Daily Treatment Log

TSS 7

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Form Required for Staff Addition

TSS 8

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Monthly Treatment Report (Co-Occuring Residential)

PROB 46-CO-RES

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Monthly Treatment Report (MH Case Management)

PROB 46-MHCM

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Monthly Treatment Report (Outpatient Mental Health)

PROB 46-MHO

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Monthly Treatment Report (Outpatient Substance Abuse)

PROB 46-SAO

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Monthly Treatment Report (Residential Substance Abuse)

PROB 46-SA-RES

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Monthly Treatment Report (Sex Offender Treatment)

PROB 46-SO

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Sample Violation Report for Vendor (Mental Health)

TSS 9-MH

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Sample Violation Report for Vendor (Substance Abuse)

TSS 9-SA

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Sweat Patch Testing Log (Client)

TSS 10

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Transportation Authorization Form

TSS 11

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Treatment Plan

TSS 15

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Treatment Services Invoice

TSS 12

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Urinalysis Log (Client)

TSS 13

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Vendor Supply Order Form

TSS 14

Last Updated:

04/16/2018

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Treatment Services and Vendor Forms