Staff Forms

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0-Credible-Clinical-Manual-with-addendums-A-G-Tx-Plan-Report.pdf Credible Clinical Manual, with addendums A-G + Tx Plan Report.pdf

Open Download Copy Link 5.87 MB 2025-10-21 October 21, 2025 2025-10-20 October 20, 2025
5.87 MB
0_-Credible-Office-Manager-Workflow-9-2025.pdf Credible Office Manager Manual, 2025.pdf

Open Download Copy Link 6.3 MB 2025-09-16 September 16, 2025 2025-09-03 September 3, 2025
6.3 MB
1-Administrative-Staff-Roles-Responsibilities.pdf Administrative Staff- Roles & Responsibilities.pdf

Open Download Copy Link 179.92 KB 2025-12-17 December 17, 2025 2025-12-16 December 16, 2025
179.92 KB
30-90-Day-Follow-Up-Report-wout-Dx.pdf

Open Download Copy Link 14.43 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
14.43 KB
30-Day-Follow-Up-Report.pdf

Open Download Copy Link 15.09 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
15.09 KB
Adult-Adolescent-Discharge-Survey.pdf

Open Download Copy Link 15.35 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
15.35 KB
Adult-Diagnostic-Interview.pdf

Open Download Copy Link 55.83 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
55.83 KB
Adult-Medication-Management-Assessment.pdf

Open Download Copy Link 54.61 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
54.61 KB
Adult-Mental-Health-Assessment.pdf

Open Download Copy Link 55.53 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
55.53 KB
Adult-Substance-Abuse-Evaluation.pdf

Open Download Copy Link 83.3 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
83.3 KB
AIMS_Form.pdf

Open Download Copy Link 17.08 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
17.08 KB
BAM-30-Day-Instrument-11-2021.pdf

Open Download Copy Link 574.27 KB 2021-12-16 December 16, 2021 2023-04-14 April 14, 2023
574.27 KB
Billing-Sheet-7-2025.pdf Billing Sheet, 7-2025.pdf

Open Download Copy Link 102.32 KB 2025-07-03 July 3, 2025 2025-07-02 July 2, 2025
102.32 KB
CAP-Assessment-Adult.pdf

Open Download Copy Link 52.41 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
52.41 KB
CAP-Assessment-Youth.pdf

Open Download Copy Link 52.62 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
52.62 KB
CASI.pdf

Open Download Copy Link 7.42 MB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
7.42 MB
CEU-Form-as-of-7-1-2026.pdf CEU Form as of 7-1-2026.pdf

Open Download Copy Link 32.47 KB 2026-07-13 July 13, 2026 2026-07-12 July 12, 2026
32.47 KB
Child-Co-Occurring-Eval.pdf

Open Download Copy Link 75.13 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
75.13 KB
Child-Diagnostic-Interview.pdf

Open Download Copy Link 56.92 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
56.92 KB
Child-Medication-Management-Assessment.pdf

Open Download Copy Link 53.12 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
53.12 KB
Child-Mental-Health-Assessment.pdf

Open Download Copy Link 56.28 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
56.28 KB
Child-Substance-Abuse-Evaluation.pdf

Open Download Copy Link 71.24 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
71.24 KB
Clients-Rights-Agency-Policy-10-2021.pdf

Open Download Copy Link 129.32 KB 2021-11-01 November 1, 2021 2023-04-14 April 14, 2023
129.32 KB
Clients-Rights-Agency-Policy-12-2018-SPANISH.pdf

Open Download Copy Link 36.57 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
36.57 KB
Co-Occurring-Evaluation.pdf

Open Download Copy Link 83.61 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
83.61 KB
Community-Support-Assessment.pdf

Open Download Copy Link 43.62 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
43.62 KB
Community_Support_Annual_Consumer_Report.pdf

Open Download Copy Link 16.12 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
16.12 KB
Community_Support_Consumer_Crisis_Plan.pdf

Open Download Copy Link 13.82 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
13.82 KB
Consent_for_Observation.pdf

Open Download Copy Link 7.61 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
7.61 KB
Contact_Note.pdf

Open Download Copy Link 10.62 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
10.62 KB
Contracted-Services-billing-form.pdf Contracted Services billing form.pdf

Open Download Copy Link 17.9 KB 2023-10-17 October 17, 2023 2021-05-24 May 24, 2021
17.9 KB
Crisis-Response-Form-3-1-2026.pdf

Open Download Copy Link 13.45 KB 2026-03-02 March 2, 2026 2026-03-01 March 1, 2026
13.45 KB
Crisis_Log.pdf

Open Download Copy Link 9.67 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
9.67 KB
CS-Flex-Funds-Reimbursement-Request-Form.pdf

Open Download Copy Link 650.25 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
650.25 KB
CS-Mileage-Sheet-as-of-7-01-2023.pdf CS Mileage Sheet as of 7-01-2023.pdf

Open Download Copy Link 30.02 KB 2023-06-30 June 30, 2023 2023-06-29 June 29, 2023
30.02 KB
CS-Referral-Form-2019.pdf

Open Download Copy Link 32.2 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
32.2 KB
Denial_of_patient_request_to_access_records.pdf

Open Download Copy Link 40.82 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
40.82 KB
Denial_of_pt__request_to_amend_records.pdf

Open Download Copy Link 41.83 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
41.83 KB
Disclosure_Log.pdf

Open Download Copy Link 12.09 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
12.09 KB
EMDR_Consent.pdf

Open Download Copy Link 14.29 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
14.29 KB
Employee-Handbook-2025.pdf Employee Handbook, 2025.pdf

Open Download Copy Link 533.72 KB 2025-09-13 September 13, 2025 2025-09-10 September 10, 2025
533.72 KB
Fax-cover-sheet-PDF-2024-Geneva-removed.pdf Fax cover sheet- PDF, 2024 (Geneva removed).pdf

Open Download Copy Link 161.13 KB 2024-05-31 May 31, 2024 2024-05-30 May 30, 2024
161.13 KB
Fax-cover-sheet-Word-doc-to-type-in-2024-Geneva-removed.docx Fax cover sheet- Word doc to type in, 2024 (Geneva removed).docx

Download Copy Link 49.57 KB 2024-05-31 May 31, 2024 2024-05-30 May 30, 2024
49.57 KB
FC_Referral_Form_to_Community_Medical_Center.pdf

Open Download Copy Link 22.35 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
22.35 KB
Financial-Policy-client-9-2025.pdf Financial Policy (client), 9-2025.pdf

Open Download Copy Link 376.88 KB 2025-09-03 September 3, 2025 2025-08-26 August 26, 2025
376.88 KB
Financial-Policy-SPANISH-9-2025.pdf Financial Policy (SPANISH) 9-2025.pdf

Open Download Copy Link 17.12 KB 2025-09-03 September 3, 2025 2025-08-28 August 28, 2025
17.12 KB
Full-Fee-Cheat-Sheet-eff-9-2025.pdf Full Fee Cheat Sheet, eff 9-2025.pdf

Open Download Copy Link 462.29 KB 2025-09-03 September 3, 2025 2025-09-02 September 2, 2025
462.29 KB
Gambling-Intake-Data-Client-2026-2027.pdf Gambling Intake Data (Client), 2026-2027.pdf

Open Download Copy Link 305.55 KB 2026-07-01 July 1, 2026 2026-06-30 June 30, 2026
305.55 KB
Gambling-Intake-Data-Family-Member-2026-2027.pdf Gambling Intake Data (Family Member), 2026-2027.pdf

Open Download Copy Link 170.61 KB 2026-07-01 July 1, 2026 2026-06-30 June 30, 2026
170.61 KB
Grievance-Policy-11-2020-SPANISH.pdf

Open Download Copy Link 50.59 KB 2021-06-02 June 2, 2021 2023-04-14 April 14, 2023
50.59 KB
Grievance-Policy-11-2020.pdf

Open Download Copy Link 5.11 KB 2021-06-02 June 2, 2021 2023-04-14 April 14, 2023
5.11 KB
Group_Progress_Note.pdf

Open Download Copy Link 40.77 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
40.77 KB
Guest_speaker_agreement_form.pdf

Open Download Copy Link 11.1 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
11.1 KB
Hardship_Form.pdf

Open Download Copy Link 17.49 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
17.49 KB
History_of_non-routine_disclosures_request.pdf

Open Download Copy Link 29.67 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
29.67 KB
Incident-Report-Instructions-and-paper-form-if-needed-7-2025.pdf Incident Report Instructions (and paper form if needed), 7-2025.pdf

Open Download Copy Link 418.15 KB 2025-07-22 July 22, 2025 2025-07-21 July 21, 2025
418.15 KB
Injectable_Order_Form.pdf

Open Download Copy Link 34.21 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
34.21 KB
Interpretive_services_agreement_form.pdf

Open Download Copy Link 42.79 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
42.79 KB
IOP-OP-Agreement-Form-3-2019.pdf

Open Download Copy Link 45.33 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
45.33 KB
IOP-OP_sign_in_sheet.pdf

Open Download Copy Link 9.09 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
9.09 KB
JotPsych-Consent-12-2024.pdf JotPsych Consent, 12-2024.pdf

Open Download Copy Link 100.06 KB 2024-12-23 December 23, 2024 2024-12-22 December 22, 2024
100.06 KB
JotPsych-Consent-SPANISH-10-2025.pdf JotPsych Consent (SPANISH), 10-2025.pdf

Open Download Copy Link 366.51 KB 2025-10-20 October 20, 2025 2025-10-15 October 15, 2025
366.51 KB
Laboratory-Requisition-Form.pdf

Open Download Copy Link 13.35 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
13.35 KB
Lincoln_CS_flex_funds.pdf

Open Download Copy Link 20.96 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
20.96 KB
LPS-Mileage-Form-7-1-2026.pdf LPS Mileage Form, 7-1-2026.pdf

Open Download Copy Link 32.29 KB 2026-07-13 July 13, 2026 2026-07-12 July 12, 2026
32.29 KB
Med-Contact-Note-5-2019.pdf

Open Download Copy Link 87.05 KB 2022-08-23 August 23, 2022 2023-04-14 April 14, 2023
87.05 KB
Med-Error-Note-8-2022.pdf

Open Download Copy Link 86.47 KB 2022-08-23 August 23, 2022 2023-04-14 April 14, 2023
86.47 KB
Medication-Management-Progress-Note.pdf

Open Download Copy Link 43.6 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
43.6 KB
Medication-Notice-SPANISH.pdf

Open Download Copy Link 288.17 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
288.17 KB
Medication_Injection_Note.pdf

Open Download Copy Link 27.91 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
27.91 KB
Medication_Removed_for_Disposal_Form.pdf

Open Download Copy Link 16.17 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
16.17 KB
MHB_Commit_90_d_wout_Dx.pdf

Open Download Copy Link 21.82 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
21.82 KB
Mileage-Sheet-as-of-7-1-2026.pdf Mileage Sheet as of 7-1-2026.pdf

Open Download Copy Link 30.97 KB 2026-07-13 July 13, 2026 2026-07-12 July 12, 2026
30.97 KB
MM-Appointment-Reminder-Card-7_2023.pdf MM Appointment Reminder Card 7.2023.pdf

Open Download Copy Link 120.48 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
120.48 KB
MM-Client-Distribution-Log-3-2022.pdf

Open Download Copy Link 283.65 KB 2022-06-07 June 7, 2022 2023-04-14 April 14, 2023
283.65 KB
MM-Consent-to-Give-Written-Prescriptions-to-Designee-3-2022.pdf

Open Download Copy Link 99.62 KB 2022-06-07 June 7, 2022 2023-04-14 April 14, 2023
99.62 KB
MM-Medication-Notice-6-2023.pdf MM Medication Notice, 6-2023.pdf

Open Download Copy Link 288.7 KB 2023-06-27 June 27, 2023 2023-06-26 June 26, 2023
288.7 KB
MM-Optional-Medication-Consent-Form-4-2022.pdf

Open Download Copy Link 271.54 KB 2022-06-07 June 7, 2022 2023-04-14 April 14, 2023
271.54 KB
MM_Symptom_Evaluation_Form.pdf

Open Download Copy Link 14.47 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
14.47 KB
MSPQ-Medicare-Secondary-Payor-Questionnaire.pdf

Open Download Copy Link 604.27 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
604.27 KB
NDBH-Consent-SPANISH.pdf

Open Download Copy Link 14.41 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
14.41 KB
NDBH_Consent.pdf

Open Download Copy Link 14.33 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
14.33 KB
Nebraska-Voter-Registration-Form-SPANISH.pdf Nebraska Voter Registration Form (SPANISH).pdf

Open Download Copy Link 179.73 KB 2025-02-04 February 4, 2025 2025-02-03 February 3, 2025
179.73 KB
Nebraska-Voter-Registration-Form.pdf Nebraska Voter Registration Form.pdf

Open Download Copy Link 189.03 KB 2025-02-04 February 4, 2025 2025-02-03 February 3, 2025
189.03 KB
NTC-Psychological-Testing-Request-Form.pdf

Open Download Copy Link 446.19 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
446.19 KB
NTC_IOP-Day_Treatment_Authorization_Form.pdf

Open Download Copy Link 181.36 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
181.36 KB
OQ-45_2.pdf OQ-45.pdf

Open Download Copy Link 39.22 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
39.22 KB
OQ-2025-SPANISH.pdf OQ-45 (SPANISH).pdf

Open Download Copy Link 32.42 KB 2025-01-03 January 3, 2025 2025-01-02 January 2, 2025
32.42 KB
Patient-Records-Access-Request-Form-10-2024.pdf Patient Records Access Request Form 10-2024.pdf

Open Download Copy Link 174.42 KB 2024-10-23 October 23, 2024 2024-10-22 October 22, 2024
174.42 KB
Patient-Records-Access-Request-Form-SPANISH-10-2024.pdf Patient Records Access Request Form (SPANISH) 10-2024.pdf

Open Download Copy Link 165.4 KB 2024-10-23 October 23, 2024 2024-10-22 October 22, 2024
165.4 KB
Patient_Assistance_Tracking_Form.pdf

Open Download Copy Link 12.94 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
12.94 KB
Patient_request_to_amend_records.pdf

Open Download Copy Link 41.98 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
41.98 KB
Petty_Cash_Reimbursment_Record.pdf

Open Download Copy Link 7.64 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
7.64 KB
Privacy-notice-2-2026-SPANISH.pdf

Open Download Copy Link 216.26 KB 2026-02-23 February 23, 2026 2026-02-22 February 22, 2026
216.26 KB
Privacy-Practices-Notice-2-page-2-2026.pdf

Open Download Copy Link 123.86 KB 2026-02-23 February 23, 2026 2026-02-22 February 22, 2026
123.86 KB
Privacy-Practices-Notice-Full-Version-2-2026.pdf

Open Download Copy Link 124.92 KB 2026-02-23 February 23, 2026 2026-02-22 February 22, 2026
124.92 KB
Progress-Note.pdf

Open Download Copy Link 36.06 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
36.06 KB
Psychological-Evaluation.pdf

Open Download Copy Link 83.74 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
83.74 KB
Purchase_Requisition.pdf

Open Download Copy Link 20.37 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
20.37 KB
Receipt-Log-Cash-Check.pdf Receipt Log- Cash & Check.pdf

Open Download Copy Link 488.9 KB 2024-02-23 February 23, 2024 2024-02-19 February 19, 2024
488.9 KB
Receipt-Log-Credit-Card.pdf Receipt Log- Credit Card.pdf

Open Download Copy Link 485.69 KB 2024-02-23 February 23, 2024 2024-02-19 February 19, 2024
485.69 KB
Registration-Consent-9-2025-SPANISH.pdf

Open Download Copy Link 139.62 KB 2026-02-24 February 24, 2026 2026-02-23 February 23, 2026
139.62 KB
Registration-Consent-9-2025.pdf Registration Consent 9-2025.pdf

Open Download Copy Link 604.43 KB 2025-09-03 September 3, 2025 2025-08-28 August 28, 2025
604.43 KB
Registration-Form-6-2026-SPANISH.pdf Registration Form 6-2026 (SPANISH).pdf

Open Download Copy Link 121.56 KB 2026-07-28 July 28, 2026 2026-07-27 July 27, 2026
121.56 KB
Registration-Form-6-2026.pdf Registration Form 6-2026.pdf

Open Download Copy Link 410.52 KB 2026-07-28 July 28, 2026 2026-07-27 July 27, 2026
410.52 KB
Report-of-Complaint-Rev-5-2018.pdf

Open Download Copy Link 12.32 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
12.32 KB
ROI-Disclose-Crete-2018-SPANISH.pdf

Open Download Copy Link 27.63 KB 2020-05-05 May 5, 2020 2023-04-14 April 14, 2023
27.63 KB
ROI-Obtain-Crete-2018-SPANISH.pdf

Open Download Copy Link 28.09 KB 2020-05-05 May 5, 2020 2023-04-14 April 14, 2023
28.09 KB
ROI-ObtainDisclose-Auburn-2023.pdf ROI (Obtain+Disclose)- Auburn, 2023.pdf

Open Download Copy Link 273.64 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
273.64 KB
ROI-ObtainDisclose-Beatrice-2023.pdf ROI (Obtain+Disclose)- Beatrice, 2023.pdf

Open Download Copy Link 273.96 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
273.96 KB
ROI-ObtainDisclose-Crete-2023.pdf ROI (Obtain+Disclose)- Crete, 2023.pdf

Open Download Copy Link 273.65 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
273.65 KB
ROI-ObtainDisclose-David-City-2023.pdf ROI (Obtain+Disclose)- David City, 2023.pdf

Open Download Copy Link 274.2 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
274.2 KB
ROI-ObtainDisclose-Fairbury-2023.pdf ROI (Obtain+Disclose)- Fairbury, 2023.pdf

Open Download Copy Link 275.1 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
275.1 KB
ROI-ObtainDisclose-Falls-City-2023.pdf ROI (Obtain+Disclose)- Falls City, 2023.pdf

Open Download Copy Link 274.57 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
274.57 KB
ROI-ObtainDisclose-Lincoln-2023.pdf ROI (Obtain+Disclose)- Lincoln, 2023.pdf

Open Download Copy Link 274.55 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
274.55 KB
ROI-ObtainDisclose-NE-City-2023.pdf ROI (Obtain+Disclose)- NE City, 2023.pdf

Open Download Copy Link 274.58 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
274.58 KB
ROI-ObtainDisclose-Seward-2023.pdf ROI (Obtain+Disclose)- Seward, 2023.pdf

Open Download Copy Link 274.57 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
274.57 KB
ROI-ObtainDisclose-Wahoo-2023.pdf ROI (Obtain+Disclose)- Wahoo, 2023.pdf

Open Download Copy Link 273.65 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
273.65 KB
ROI-ObtainDisclose-York-2023.pdf ROI (Obtain+Disclose)- York, 2023.pdf

Open Download Copy Link 272.97 KB 2023-11-03 November 3, 2023 2023-11-02 November 2, 2023
272.97 KB
Sample_Log_Form.pdf

Open Download Copy Link 58.41 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
58.41 KB
SAVE_Verification_Request_Form.pdf

Open Download Copy Link 28.94 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
28.94 KB
SA_Voucher_Tracking_Form.pdf

Open Download Copy Link 19.32 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
19.32 KB
Service-Note-CS-Goals-and-Objectives.pdf

Open Download Copy Link 35.88 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
35.88 KB
Service-Note.pdf

Open Download Copy Link 32.48 KB 2020-05-07 May 7, 2020 2023-04-14 April 14, 2023
32.48 KB
Sliding-Fee-Eligibility-Form-7-2026-SPANISH.pdf Sliding Fee Eligibility Form 7-2026 (SPANISH).pdf

Open Download Copy Link 329.05 KB 2026-07-28 July 28, 2026 2026-06-14 June 14, 2026
329.05 KB
Sliding-Fee-Eligibility-Form-eff-7-2026.pdf Sliding Fee Eligibility Form, eff 7-2026.pdf

Open Download Copy Link 312.49 KB 2026-07-28 July 28, 2026 2026-06-14 June 14, 2026
312.49 KB
Sliding-Fee-Memo-to-Finance-Director-10-2021.pdf

Open Download Copy Link 502.66 KB 2021-11-01 November 1, 2021 2023-04-14 April 14, 2023
502.66 KB
Sliding_Fee-CDS_Admission_Form.pdf

Open Download Copy Link 33.28 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
33.28 KB
Sliding_Fee-Discharge-Summary_Form.pdf

Open Download Copy Link 15.16 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
15.16 KB
SOGS-Scoring-Rules.pdf SOGS Scoring Rules.pdf

Open Download Copy Link 59.32 KB 2025-01-13 January 13, 2025 2025-01-12 January 12, 2025
59.32 KB
SOQ_.pdf

Open Download Copy Link 26.52 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
26.52 KB
SOQ_Spanish.pdf

Open Download Copy Link 38.26 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
38.26 KB
South-Oaks-Gambling-Screen-SOGS-1-2025.pdf South Oaks Gambling Screen (SOGS), 1-2025.pdf

Open Download Copy Link 116.03 KB 2025-01-13 January 13, 2025 2025-01-12 January 12, 2025
116.03 KB
Supervisory_Contact_Note.pdf

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11.74 KB
TASC_Program_Referral_Form.pdf

Open Download Copy Link 64.2 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
64.2 KB
Telehealth-Consent-SPANISH.pdf

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294.73 KB
Telehealth_Consent.pdf

Open Download Copy Link 501.53 KB 2020-08-25 August 25, 2020 2023-04-14 April 14, 2023
501.53 KB
Transportation_Consent.pdf

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10.86 KB
Treatment-Plan-Review.pdf

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19.34 KB
Updated-SA-Service-Note-Adult.pdf

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43.05 KB
Updated-SA-Service-Note-Child.pdf

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37.58 KB
Video-filming-release-5-2022.pdf

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109.09 KB
Waiting-List.pdf

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16.36 KB
Waiver_of_Liability_Statement.pdf

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10.08 KB
Weekly_Probation-Parole_Note.pdf

Open Download Copy Link 6.98 KB 2020-05-01 May 1, 2020 2023-04-14 April 14, 2023
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YAP-Assessment.pdf

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