Substance Use Disorder Templates

This form is used for obtaining informed consent from pregnant individuals with opioid/opiate use disorder in Texas who are seeking treatment.

This document outlines the plan of care for individuals seeking addiction and recovery services in Nevada under the Comprehensive Addiction and Recovery Act (CARA).

This form is used for issuing a summons for involuntary treatment for substance use disorder in the state of Kentucky. It is a legal document that initiates the process of involuntarily admitting an individual for treatment.

This form is used for issuing a Sheriff Transport and Examination Order for involuntary treatment of individuals with substance use disorder in Kentucky.

This form is used for ordering a 72-hour hospitalization for individuals with substance use disorder in Kentucky.

This form is used for reporting substance use disorder in the state of Nevada. It helps individuals provide information about their own substance abuse for assessment and treatment purposes.

This document is for applying for the Child Care Assistance Program (CCAP) in Rhode Island.

This form is used for documenting substance use disorder requirements for individuals receiving assistance through the Abd/Pwa program in Washington. It is important for individuals to complete this form accurately to ensure they meet the necessary requirements for continued assistance.

This document is a cover page addendum specifically designed for the Maryland Medical Assistance Program Application for facility/organization categorized as Pt 54 Imd Residential Sud Adult in Maryland.

This document discusses the impact of parental substance use on the child welfare system. It explores how substance abuse can lead to child abuse and neglect, and the interventions and support available for families affected by this issue.

This type of document, DOH Form 670-147 Substance Use Disorder Professional Enhancement Plan (Ep) - Washington, is used for developing a plan to enhance the skills and knowledge of professionals working in the field of substance use disorder treatment in the state of Washington.

This form is used for verifying the qualifications and professional status of substance use disorder professionals in Washington state.

This renewal application is used for individuals in South Dakota seeking prevention, substance use disorder, and/or mental health services.

This form is used to measure the initial outcomes of family members with substance use disorders in South Dakota.

This type of document is used to evaluate the outcome of discharging adults with substance use disorder in South Dakota.

This document is a tool used in South Dakota to assess the initial outcomes of youth with substance use disorder.

This form is used for substance use disorder attestation in Washington, D.C. It is used to confirm the individual's commitment to abstain from substance use and comply with treatment.

This document is used for recertification of Comprehensive Community Services (CCS) for individuals with mental disorders and substance use disorders in Wisconsin.

This form is used for releasing information related to substance use disorder services in Washington state. It allows individuals to authorize the sharing of their treatment records for substance abuse treatment purposes.

This type of document is used for releasing information regarding substance use disorder services in Washington for Somali individuals.

This form is used for releasing information related to Substance Use Disorder (SUD) Services in Washington State. It is available in both English and Russian.

This form is used for requesting prior authorization for substance use disorder services in Ohio.

This form is used for applying for the Comprehensive Community Services (CCS) program in Wisconsin. It is specifically for individuals with mental disorders and substance use disorders. The form is a supplemental application for the Regional Model of CCS.