Click on the form name to print a copy of the form for your use.

For All Clients
Breathalyzer/Monitored Medication Report
Consent for Release of Confidential Information
Consent for Follow-Up Contact
Consent—General—Release AND Non-PHI Receive - Non-Medical
Consent—General—Release AND PHI Receive - Medical
Consent—Doctor/Dentist
Consent—Emergency Contact
Consent—Employer
Consent—Norchem
Consent—Probation Officer
Consent—Psychiatrist/Psychologist
Consent—Sponsor
Consent—Spouse
Consent—Therapist
Consent—Treatment Center
Consent—UA Site
Contact Change Form
Monthly Meeting List Report
Pain Management Provider Report
Practice Monitor Report (General)
Psychiatrist Report
Relapse Prevention Plan
Self-Status Report
Sponsor Report
Therapist Report
Treatment Provider Report
Urinalysis/Monitored Medication Report
Urine Screening Standards 
Vacation/Travel Request

For Nurses
Nurse Supervisor Report
Client Handbook 
Provider Verification Form
Consent—SBON
Contract Change Request Procedure
FAQ
Checklist for Employment

For Dentists
Client Handbook
Consent—CBDE 
Consent—School of Dental Medicine
Dentist Practice Monitor Report To complete this 6 page form, you may either
Download, print, complete by hand and sign, OR
Complete the form on line. Check the boxes and fill in the required narrative, "save as" to your computer's hard drive, print and sign.

For Pharmacists
Client Handbook
Consent—SBOP 
Consent—School of Pharmacy
Pharmacist Supervisor Report
Provider Verification Form

For Fee For Service
Registered Dental Hygenist Supervisor Report
Veterinarian Supervisor Report
Respiratory Therapist Supervisor Report
Mental Health Professional Supervisor Report
Chiropractor Supervisor Report