Substance Abuse Templates

This form is used for verifying substance abuse and mental health treatment in Florida.

This document is used for contractors in Idaho to declare their commitment to maintaining an alcohol and drug-free workplace. It affirms their compliance with state laws.

This form is used for conducting interviews with individuals seeking syringe services in New Mexico.

This document is used for agreeing to temporary work release for individuals charged with an OWI (Operating While Intoxicated) in Iowa.

This form is used for making referrals to assess and treat substance abuse in children involved in the child welfare system in Oklahoma.

This form is used for conducting a reasonable suspicion checklist as part of employee drug testing in the state of Oklahoma. It helps employers determine whether there is reasonable suspicion to believe that an employee is under the influence of drugs or alcohol.

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 document provides instructions for completing Form F-11033 Prior Authorization/Mental Health and/or Substance Abuse Evaluation Attachment (Pa/Ea) in Wisconsin. It provides guidance on how to fill out the form and includes important information about the prior authorization process for mental health and substance abuse evaluations.

This form is used for providing instructions on how to complete Form F-11032 Prior Authorization/Substance Abuse Attachment (PA/SAA) in Wisconsin. It is a required document for obtaining prior authorization for substance abuse treatment.

This form is used for reporting incidents involving alcohol or drug influence in Wisconsin. It is important for documenting and investigating cases related to impaired driving and substance abuse.

This form is used for making an initial referral for screening in the Veterans Treatment Court program in San Mateo County, California. It is meant for veterans who may be eligible to participate in the specialized court program.

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 document is used for declaring completion of an approved education program in Washington for professionals training in substance use disorder.

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 assess the outcomes of individuals with a family history of substance use disorder upon discharge in South Dakota.

This form is used for recording information about controlled substances in Virginia.

This form is used for referring individuals in Texas who are in need of high-risk counseling services.

This document is for reporting incidents of drug diversion in Vermont. It provides a way for individuals to report suspicious activities or behaviors related to the illegal use or distribution of drugs.

This form is used for filing a complaint against a substance abuse treatment facility or program in Washington, D.C. It is affiliated with the Addiction Prevention and Recovery Administration.

This Form is used for attesting to Substance Use Disorder in Washington, D.C. for the CPC-Hie program.

This form is used for submitting a certified drug-free workplace report in West Virginia.

This Form is used for applying for initial certification of ambulatory detoxification services for substance abuse in Wisconsin.

This form is used for applying for the initial certification of a medically managed residential detoxification service as part of Wisconsin's Community Substance Abuse Service (CSAS) program.

This type of document is used in Wisconsin for submitting a Prior Authorization/Mental Health and/or Substance Abuse Evaluation Attachment.

This document is a form used in Wisconsin for obtaining prior authorization for substance abuse day treatment.

This Form is used for applying for initial certification as a Community Substance Abuse Service (CSAS) Medically Monitored Treatment Service in Wisconsin.

This form is used for applying for assistance with an Ignition Interlock device in the state of Wyoming.

This document is used for attesting to the chronic use of opioids in the state of Washington.

This form is used for requesting prior authorization for a urine drug test in the state of Vermont. It helps ensure that the test will be covered by insurance.

This document is used for applying for a drug-free workplace program in the state of Kentucky. It provides the necessary information and forms to meet the requirements of a drug-free workplace.

This form is used for applying for Intervention in Lieu of Conviction in Butler County, Ohio. It is a legal process that allows eligible individuals charged with a crime to undergo treatment or counseling instead of going through the traditional criminal justice system.

This document is for the Drug Treatment Court colloquy in Snyder County, Pennsylvania. It provides information and guidelines related to the court proceedings and processes for individuals involved in drug treatment programs.

This form is used for registering a recovery house in the state of New Hampshire.

This Form is used for obtaining consent from applicants in Kentucky for drug screening through urinalysis as part of the K-1 application process.

This Form is used for quarterly reporting for the New Hampshire Syringe Services Program in New Hampshire.

This document is a Substance Abuse Intake Questionnaire specifically designed for residents of New Hampshire. It is used to gather important information about individuals seeking substance abuse treatment in the state.