Recovery Technology

Recovery Technology LLC

Recovery Technology Forms

Recovery Technology Forms


ABA Therapy Schedule Form

Access to Case Record

Acknowledgement of IPOS Delivery

Administered Medication Documentation

Advance Directive (print only)

Against Medical Advice

AM-BIP Packet

Assessment and Treatment Plan

Assignment of Benefits

ATO – Doctor Letter

Barrier Report

Billing Form

Billing Form – Spravato

Bomb Threat Procedures

Business Satisfaction Survey

Child & Adolescent Attachment to Assessment & Treatment Plan

Choice of Provider

Circle of Supports (MAPS)

Client Satisfaction Survey

Clinical Record Review Tool

Clinician Transfer

Communication and Message Consent Form

Confidential Complaint Form

Confidentiality Agreement

Consent for Participation In A Mental Health Program

Consent To Participate In BIP/AM Group

Consent to Participate in Services

Consent for Release of Confidential Information

Consent for Spravato

Crisis Plan

DBT Diary Card

DBT Group Rules

DBT Program Contract

DBT Telephone Skills Coaching

DBT Ten Benefits of Diary Cards

DCH 712 Form

Death Report (Private)

Deductible Spend Down

Demographic Form

Demographic Changes/Updates

DHS 54A Form

Discharge Form (1 page)

Discharge Form with Outcomes

Discharge/Transitional Summary-Plan

Duty to Warn

Family Input

Fax Cover Sheet RT

Fax Cover Sheet RT – ACT

Financial Determination Reminder

First Time Appointment Billing Form

First Time Appointment Packet- ACT/CSM

First Time Appointment Packet – OPT (LifeWays Clients)

First Time Appointment Packet – OPT (Private Clients)

Full Cost Agreement

Group Attendance Rules – BIP/AM

Group Billing RT

Group Rules – BIP/AM

IDDT Staging

Incident Report

Informal Complaint Process

Intake Packet – Groups – BIP/AM

Invoice-Medical Records

Ketamine Guidelines, Protocol, Consent