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Vendor Forms

Form Title: Daily Treatment Log
Form Number:
Attachment J.6

Log for tracking treatment of clients. Complete one form per client per month.

Form Title: Treatment Services Invoice
Form Number:
Attachment J.8

The Administrative Offices of the United States Courts treatment services invoice. Part A & Part B.

Form Title: Additional Treatment Logs
Form Number:
Attachment J.9

Includes Breathalyzer Instrument Log, Breathalyzer Log, Sweat Patch Testing Log, and Urinalysis Testing Log.

Form Title: Authorization to Release Confidential Information (Drug Abuse Programs)
Form Number:
PROB 11B

United States Probation system authorization to release confidential information from drug abuse programs.

Form Title: Authorization to Release Confidential Information (Substance Abuse & Mental Health)
Form Number:
Prob 11E

United States Probation system authorization to release confidential information from substance abuse and mental health treatment programs.

Form Title: Authorization to Release Confidential Information (Mental Health Treatment)
Form Number:
Prob 11I

United States Probation system authorization to release confidential information from mental health treatment programs.

Form Title: Travel Log
Form Number:
Prob 17

Unites States Probation and Pretrail services travel log.

Form Title: Monthly Treatment Report
Form Number:
Prob 46

Form to be completed and submitted with each monthly billing. Additional information may be included.

Form Title: Authorization to Release Confidential Information (Drug & Alchohol Programs)
Form Number:
PS 6B

Authorization to release confidential information for drug and alchohol abuse programs.

Form Title: Authorization to Release Confidential Information (PS) (Mental Health Treatment)
Form Number:
PS 6D

United States Pretrial services system authorization to release confidential information from mental health treatment programs.