Pennsylvania Department of Drug and Alcohol Programs Forms

23
total templates

Documents

23

Form DDAP-EFM-1500 "Coroner's Drug Death Report" - Pennsylvania

Rate (4.5 / 5) 61 votes
Size: 1 MB
3 pages

Form DDAP-EFM-1303 "Request for Liability Reduction or Elimination Form" - Pennsylvania

Rate (4.8 / 5) 97 votes
Size: 1 MB
1 page

Form DDAP-EFM-1302 "Gambling Screening Tool" - Pennsylvania

Rate (4.7 / 5) 15 votes
Size: 296 KB
2 pages

Form DDAP-EFM-1301 "Gambling Treatment Program Provider Application - Sole Practitioner" - Pennsylvania

Rate (4.6 / 5) 17 votes
Size: 505 KB
3 pages

Form DDAP-EFM-1320 "Request for Client Authorization" - Pennsylvania

Rate (4.3 / 5) 8 votes
Size: 501 KB
1 page

Form DDAP-EFM-1300 "Gambling Treatment Program Provider Application - Agency" - Pennsylvania

Rate (4.6 / 5) 9 votes
Size: 500 KB
3 pages

Form DDAP-EFM-1305 "Gambling Discharge Treatment Form" - Pennsylvania

Rate (4.4 / 5) 11 votes
Size: 419 KB
2 pages

Form DDAP-EFM-1304 "Gambling Treatment Program Admission Form" - Pennsylvania

Rate (4.8 / 5) 13 votes
Size: 1 MB
3 pages

"Request for Licensing Application Packet" - Pennsylvania

Rate (4.8 / 5) 6 votes
Size: 212 KB
1 page

"Unusual Incident Reporting Form - Narcotic Treatment Program" - Pennsylvania

Rate (4.4 / 5) 44 votes
Size: 113 KB
2 pages

"Unusual Incident Reporting Form - Non-narcotic Treatment Program" - Pennsylvania

Rate (4.3 / 5) 17 votes
Size: 114 KB
2 pages

"Narcotic Treatment Program Unusual Incident Reporting Form" - Pennsylvania

Rate (4.8 / 5) 8 votes
Size: 115 KB
2 pages

"Non-narcotic Treatment Program Unusual Incident Reporting Form" - Pennsylvania

Rate (4.3 / 5) 17 votes
Size: 115 KB
2 pages

"Treatment Assignment Protocol Assessment (Tap) - Client Info" - Pennsylvania

Rate (4.6 / 5) 83 votes
Size: 476 KB
14 pages

"Event Request Form" - Pennsylvania

Rate (4.5 / 5) 63 votes
Size: 51 KB
2 pages

"Email Registration Request for Facility Directors or Their Designee" - Pennsylvania

Rate (4.7 / 5) 75 votes
Size: 76 KB
1 page

"Password Agreement for Facility Directors" - Pennsylvania

Rate (4.8 / 5) 63 votes
Size: 115 KB
1 page

"Information Requested of Persons and Entities Applying to Operate a Drug and Alcohol Treatment Facility/Narcotic Treatment Program or Changing Ownership at a Drug and Alcohol Treatment Facility/Narcotic Treatment Program" - Pennsylvania

Rate (4.3 / 5) 83 votes
Size: 131 KB
13 pages

"Gambling Invoice Form - Group Sessions" - Pennsylvania

Rate (4.4 / 5) 14 votes
Size: 165 KB
1 page

"Gambling Invoice Form - Individual Sessions" - Pennsylvania

Rate (4.6 / 5) 9 votes
Size: 165 KB
1 page

"Individual Sessions Invoice for Payment" - Pennsylvania

Rate (4.6 / 5) 13 votes
Size: 163 KB
1 page

"Group Sessions Invoice for Payment" - Pennsylvania

Rate (4.7 / 5) 15 votes
Size: 162 KB
1 page