Substance Abuse Templates

This Form is used for evaluating a person's level of chemical dependency or addiction. It assists in assessing the severity of the problem and determining appropriate treatment options.

This document is a template for a certificate that certifies an individual as being free from methamphetamine use. It can be used as evidence of sobriety.

This type of document is a template for a Heroin Free Certificate of Sobriety. It can be used to recognize and celebrate someone's achievement of overcoming heroin addiction.

This document is a template for a certificate of sobriety for individuals who have been marijuana-free. It can be used to recognize and acknowledge their commitment to staying free from marijuana use.

This template is used to create a Drug Free Certificate of Sobriety. It can be used to certify that an individual is drug-free and has successfully completed a sobriety program or has been sober for a specified period of time. This document can be helpful for individuals seeking employment, participating in sports or other activities that require proof of sobriety.

This type of document is a template for a certificate that acknowledges an individual's sobriety and freedom from substance abuse. It can be used to recognize and celebrate their commitment to a sober lifestyle.

This document is a template for a Drug Free Certificate. It can be used to recognize individuals or organizations that have successfully completed a drug-free program or initiative.

This document is a template for a certificate that recognizes an individual's seven years of sobriety. It can be used for various purposes such as celebrations, support groups, or personal achievements.

This form is used for recording the results of the Ez-Cup Drug Screen test conducted by U.S. Diagnostics.

This Form is used for assessing drug abuse in individuals and helping to identify those who may need treatment or intervention. The DAST template was developed by the US Preventive Services Task Force.

This document is a flow-sheet for the clinical opiate withdrawal scale (COWS). It is used to assess and monitor the symptoms of opiate withdrawal in patients.

This document is used to verify attendance at Alcoholics Anonymous/Narcotics Anonymous meetings.

This document provides a classification table and detection time chart for urine drug testing. It helps to understand which drugs can be detected and how long they can stay in the body.

This form is used for creating a treatment plan for substance abuse prevention and control in the County of Los Angeles, California.

This document is used for certifying that grantees, who are not individuals, comply with the drug-free workplace requirements.

This document is used for conducting an inventory of controlled substances. It is used by the military to ensure accountability and proper management of these substances.

This form is used for the Army Substance Abuse Program. It is a statement of understanding that individuals must complete.

This Form is used for entering into a service agreement with New York's Impaired Driver Program for individuals participating in the program.

This form is used for creating an individualized treatment plan for mental health and substance abuse in the state of Florida.

This form is used for reviewing and updating an individualized treatment plan for mental health and substance abuse in the state of Florida.

This form is used for summarizing mental health and substance abuse referrals in Florida.

This form is used for documenting the discharge summary of an individual who received mental health or substance abuse treatment in Florida.

This form is used for obtaining consent from youth for substance abuse treatment in Florida.

This form is used for screening and diagnosing mental health and substance abuse issues in children as part of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program in Delaware.

This form is used for the discharge of individuals who have completed outpatient treatment for mental health and substance abuse issues in Delaware.

This form is used for reauthorizing outpatient treatment for mental health and substance abuse in the state of Delaware.

This form is used for referring individuals with mental health or substance abuse issues to outpatient treatment facilities in Delaware.

This form is used for conducting a preliminary screening for substance abuse and mental health issues. It is known as the M.A.Y.S.I. questionnaire form and is used in the state of Florida.

This form is used for the preliminary screening of substance abuse and mental health in Creole language in Florida.

This form is used for screening and referral of individuals with mental health and substance abuse issues in the state of Florida.

This Form is used for attesting the supervising provider of a Substance Use Disorder Clinic in Colorado.

This Form is used for reporting substance dependence or abuse in the state of Alabama.

This form is used for screening adults for substance abuse in the state of Illinois. It helps identify individuals who may be in need of treatment or intervention for substance abuse issues.

This form is used for obtaining consent to disclose information related to substance abuse assessment and/or treatment in the state of Illinois.

This form is used for collecting data on youth alcohol and other drug abuse indicators in the state of Illinois. It helps in tracking and monitoring substance abuse trends among youth in the state.

This Form is used for Substance Affected Families Procedures Checklist in Illinois.

This form is used for tracking attendance at 12 Step meetings in Nevada.

This Form is used for transferring controlled substances in the state of Missouri. It helps ensure proper documentation and accountability for the movement of these substances.