AA Attendance Record It is your responsibility to attend at least AA meetings per week. This form is to be brought back to the U.S. Probation Office each week that you are in treatment.
Date added: December 27, 2012 - Views: 186
ATTENDANCE FORM FOR ALCOHOLICS/NARCOTICS ANONYMOUS MEETINGS NAME: SUPERVISION OFFICER: The above captioned individual is required by his supervision conditions to attend Alcoholics Anonymous meetings.
Date added: April 28, 2014 - Views: 1
arizona state board of nursing 4747 north 7th street, suite 200 phoenix, arizona 85014-3655 (602) 771-7865 fax (602) 771-7882 aa/na attendance report
Date added: February 22, 2012 - Views: 36
Attendance Form for Alcoholics/Narcotics Anonymous or Independent Outpatient Meetings. Full Name Department Job Title Supervisor University ID The above named individual is required to attend these meetings.
Date added: March 28, 2012 - Views: 100
Attendance Record for Alcoholics or Narcotics Anonymous Meeting/Alcohol Awareness Class Name: _____ Case No. _____ The above named individual is required by the terms of his Occupational Driver’s License to attend Alcoholics/Narcotics Anonymous
Date added: October 8, 2011 - Views: 237
General: AA-Alcoholics Anonymous Specific: ... NA-Narcotics Anonymous RECOVERY PROGRAM MEETING ATTENDANCE LOG *Types of meeting (indicate both general and specific type): Title: Recovery Program Meeting Attendance Log.xls Author: hprather
Date added: February 17, 2012 - Views: 346
12 Step Meeting Attendance Sheet AA/NA/CA/DRA/GA Name: _____ Phase :_____ Week of: _____ Date Group Chairperson Time Signature: _____ Date: _____ * Phase I & II ...
Date added: October 25, 2012 - Views: 179
A.A./N.A./C.A. ATTENDANCE VERIFICATION NAME _____ IS TO ATTEND A MINUMUM OF _____ MEETINGS PER WEEK Directions : Fill in date & time then at the beginning of meeting, hand this form to chairperson or secretary so at the
Date added: October 25, 2012 - Views: 80
AA/NA neither endorses nor opposes any causes or organizations. PROOF OF ATTENDANCE AT AA/NA MEETINGS DATE NAME AND LOCATION OF GROUP NAME OF SIGNER TELEPHONE # Title: TO WHOM IT MAY CONCERN: Created Date:
Date added: January 28, 2012 - Views: 109
MONITORING - AA/NA ATTENDANCE REPORT NAME: TIME PERIOD COVERED BY THE REPORT: FROM:_____TO:_____ SPONSOR’S NAME: SPONSOR ... Below, and on the other side of this form, LIST ONLY AA/NA/CA meetings, the date you attended, and
Date added: January 5, 2013 - Views: 3
ca, aa, na chairperson sign or initial required: sponsor comments on step work/progress/ other: ... 12-step meeting attendance sheet author: mary messinger created date: 10/26/2012 3:18:20 pm ...
Date added: May 3, 2013 - Views: 112
Microsoft Word - Verification of Meeting Attendance (AA, NA, MA) Author: btwhite Created Date: 8/21/2012 11:23:43 AM ...
Date added: May 6, 2013 - Views: 19
AA Hotline 248.541.6565 AA Booklet Information 248.541.7490 ... Please do not sign this form until the completion of the meeting. Your cooperation in this matter is appreciated. ... Microsoft Word - AA NA Attendance Record Author:
Date added: October 31, 2011 - Views: 94
AA/NA/GA VERIFICATION SHEET Due to your special condition(s), you are required to attend one (or ____ ) AA, NA or GA meetings per week. You must have the secretary of the meeting sign this form AFTER THE
Date added: February 3, 2012 - Views: 284
Table 4.3 Attendance of AA/NA Meetings and Abstinence from ... Alcoholics Anonymous and Narcotics Anonymous meetings, rather than the entire ... AA/NA meetings and abstinence form alcohol and/or drugs within the demographics of
Date added: August 12, 2013 - Views: 8
Monthly Attendance Verification - Self-Help Meetings 1 of 1 www.hprp.org ... This form is used to verify that I have attended the following self-help group meetings (AA, NA, Caduceus, Al-Anon, Nar-Anon, etc.)
Date added: May 10, 2013 - Views: 46
sdsc crm-190 (rev. 12/13) aa/na/ca/ma meeting attendance sheet superior court of california, county of san diego central division, county courthouse, 220 w. broadway, san diego, ca 92101
Date added: January 27, 2014 - Views: 5
Miami-Dade County Drug Court Program . DEFENDANT’S PROOF OF 12 STEP PROGRAM (NA/AA) ATTENDANCE . As a condition of my participation in the Miami-Dade Drug Court Program, I,
Date added: March 7, 2012 - Views: 25
Please return this form to the client at the close of the meeting. AA: (408) 374-8511 [www.aasanjose.org]; NA: (408) 998-4200 ... * You are to provide proof of meeting attendance during the first week of each new month. You can
Date added: May 13, 2013 - Views: 5
Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment
Date added: March 28, 2012 - Views: 33
Attendance Verification Sheet _____ is to attend AA/NA meetings as ordered by the Judicial District Community Supervision and Corrections Department.
Date added: May 3, 2013 - Views: 60
United States District Court Probation Office District of Wyoming NA/AA VERIFICATION OF ATTENDANCE Name: _____ Month: _____
Date added: June 13, 2012 - Views: 12
Form CDD-104 Revised 1/2006 School Name County-District-Campus No. (If Applicable) Verification of Enrollment and Attendance (VOE) Form Planned Use of Data: To provide documentation of enrollment and attendance status to the Texas Department of Public Safety (DPS) for a
Date added: November 6, 2011 - Views: 33
support group attendance form (please make sufficient copies for your use) participant: _____ reporting month(s)_____ no. of support groups [aa, na, ca, al-anon] mtgs per week: _____ no. of nurse support group mtgs. per week: _____ sunday: - saturday ...
Date added: August 10, 2013 - Views: 6
12-step meeting attendance sheet . to be submitted by the 15th of each month due . month/year_____name:_____license #: _____ date time of day ... type: ca, aa, na chairperson sign or initial . required: sponsor comments on step work/progress/ other:
Date added: May 14, 2013 - Views: 22
AA/NA or some form of substance abuse counseling : 3. Group counseling : 4. Access to religious services : 5. Mandatory house meetings : 6. Case management support through community referrals : 7. Medication monitoring : 8.
Date added: March 25, 2012 - Views: 1
REP Meeting Attendance Forms ... (AA, NA) o Sponsor meetings o Group meetings (IOP, relapse prevention, aftercare or other treatment or group ... attending, have an AA group member or your sponsor sign the form verifying your participation.
Date added: February 16, 2014 - Views: 4
ATTENDANCE FORM FOR ALCOHOLICS/NARCOTICS ANONYMOUS MEETINGS ... Free AA Meeting Attendance Sheet Den Meeting Attendance Sheet 12 Step Meeting Attendance Sheet. Title: generic meeting attendance sheet - Bing Created Date: 2/15/2014 8:47:46 PM ...
Date added: April 14, 2014 - Views: 10
H. AA/NA attendance reported: Y N N/A . I. Any known alcohol or drug use: Y N N/A . J. Compliant with treatment: Y N K. Anticipated date of completion of ... Therapist/Counselor Report Form Author: BARBARA MORVANT
Date added: May 17, 2013 - Views: 4
program if I falsify an AA/NA attendance sheet or community services form. True False 21. If I relapse, I will be required to start Phase II ... Attendance will be required at 12-step meetings such as Narcotics Anonymous and Alcoholics Anonymous. The MINIMUM attendance requirement for the ...
Date added: September 27, 2012 - Views: 14
Meeting attendance cards (CHITS) ... example where these form part of a Drug Treatment and Testing Order (DTTO). In accordance with our Traditions and with NA World Services suggested policy, and in the light of the positive experience of both AA and NA around the world, ...
Date added: October 25, 2012 - Views: 20
J. AA/NA attendance reported: Y N N/A K. Any known alcohol or drug use: Y N N/A L. Compliant with treatment: Y N . M. Anticipated date of completion of ... Signature Date. Title: Psychiatrist/Addictionist Monthly Report Form Author: BARBARA MORVANT
Date added: May 17, 2013 - Views: 5
Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Secular Organizations for Sobriety (SOS), or any faith based support groups a minimum of two (2) times ... Continue weekly attendance at community-based support groups activities a
Date added: November 20, 2012 - Views: 3
Use this form only to request group or individual therapy for substance use disorders. For any mental health treatment requests, ... Outside AA/NA Attendance* None 1-4/Week > 4/Week Sponsorship* Nome Temporary Permanent Skill ...
Date added: November 8, 2013 - Views: 3
Monthly Group Attendance Report – Substance Use Disorder ... (Examples: AA, NA, CA, SA, Al-Anon, CODA, etc.) ... (Please fax this form to 804-828-5386 by the 10 th of the month. Thank you for your cooperation!) For Office Use Only:
Date added: December 1, 2012 - Views: 4
schedule of AA/ NA meetings in Kitsap County and reporting forms may be obtained at the ... proof of attendance filed with the Court on a court-approved form. DEFERRED PROSECUTION -- PROCEDURES:
Date added: January 28, 2012 - Views: 16
which program and attach proof of attendance: AA/NA Meeting Treatment/Counseling How often do you attend? _____ ... Please sign below stating that all of the answers on this form are true to the best of your knowledge. Please mail to the above address (please include
Date added: July 23, 2014 - Views: 1
meeting AttendAnCe NA members find that regular meeting attendance helps ... to form relationships with other recovering addicts and ... Narcotics Anonymous is not affiliated with these organizations, ...
Date added: January 29, 2012 - Views: 4
AA, NA, or other 12 step groups are probably only a good fit for a minority of people with a drug or alcohol problem. ... because of the religious content of AA meetings. Court ordered AA attendance is a violation of
Date added: February 8, 2014 - Views: 16
AA NA OTHER _____ ATTENDANCE: Regular or Sporadic *MEDICAL ISSUES: West Slope Casa Medical ... Microsoft Word - WSC RESIDENTIAL SCREENING Form 8-06.doc Author: sally Created Date:
Date added: January 5, 2013 - Views: 7
SUPPORT GROUP ATTENDANCE FORM ... REPORTING MONTH: _____ # of mtgs. per Month AA, NA, CA, AL-ANON Day Support Group Type Location Date Time Signature (1st name, last initial) chairperson or facilitator Chairperson or Facilitator’s phone ...
Date added: January 5, 2013 - Views: 3
Reimbursement Form Sign Up Sheets Timesheet Template Vacation Tracker Work ... AA / NA MEETING ATTENDANCE SHEET NAME: ... A Simple Meeting Sign-in Template | Sign in Sheets signinsheets.com/sheets/a-simple-meeting-sign-in-template
Date added: April 15, 2014 - Views: 9
83706), fax (208-323-9222), and/or email your monthly attendance form to the PRN office. Please be aware that a low meeting non-compliance letter will go ... o Mutual Support Groups (i.e. AA, NA or other 12 step) o Sponsor meetings o Group meetings (i.e. IOP, relapse prevention, ...
Date added: February 4, 2014 - Views: 5
The defendant shall attend a minimum of two (2) 12-step self help group meetings (AA, NA, etc.) per week and provide written proof of such attendance to the court at each court hearing; 2. The defendant shall comply with all court orders including Orders of Release;
Date added: May 17, 2013 - Views: 8