Research • Policy • Practice

Sample Form: Treatment

DeKalb County Doctor’s Note

“This letter is to inform you that I am a participant in the DeKalb County Drug/DUI Treatment Court program. As part of my substance abuse recovery, I cannot consume narcotic medications unless a narcotic is the only option for pain management.”

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Oakmont Center Treatment Plan Update Form

This document is for treatment staff of the Oakmont Center to explain problems of client’s and the status of the issue.

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Treatment Protocol for Benton and Franklin Counties

This document outlines the treatment protocols for the Benton and Franklin County Drug Court Program in Washington State.

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New Hope Counseling DUI Treatment Plan

This document contains the DUI treatment plan for the New Hope Counseling program in Georgia.

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Medication Assisted Treatment Protocol

This document provides one with the protocol for working with medication assisted treatment plans.

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Client Date. Counselor Date. My signature below confirms that I, in fact, participated inthistreatment plan update reviewprocess on the date indicated below.
Topics: Date, Plan, Treatment

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New Hope Counseling DUI Treatment Plan

Treatment plan for DUI’s that present the information needed by the candidate to review how the plan works.

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National Center for PTSD Clinician-Administered PTSD Scale

This document is used by clinicians to administer an assessment of incoming veterans to determine the degree of PTSD they suffer from.

Cibola County Drug Court Treatment Plan

This treatment plan is used in the WNMMG Grants Clinic to delineate the recovery goals for the client and to determine how to reach each goal to ensure one’s success.

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15th Judicial Circuit/Palm Beach County Drug Court NA/AA Proof of Attendance Form Operating Procedures

This track operational procedures form outlines the purpose, scope, and procedures that must be followed when filling out NA/AA proof of attendance forms.

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