- Home
- Government
- Health and Human Services
- Drug & Alcohol Commission
- Client Forms & Instructions
Client Forms & Instructions
Scroll down for Prevention, Fiscal and Miscellaneous information.
- 01. Admissions Form
- 02. Discharge Form
- 04. Paperwork Procedures WMS, Residential, Extending, Transfer, DC
- 04A. For the Community Based Contracted Providers Procedures to Request Funding for Residential Placement LOC
- 05. Request for Service Placement Approval
- 06. Consent to Release Information rvsd 07202023
- 06a. Consent for Re-Disclosure rvsd 07202023
- 06b. Consent for Lancaster County Treatment Courts rvsd 07202023
- 06c. Consent for LCP Pre-Parole and D2D Referrals rvsd 07202023
- 06d. Consent for Multiple Treatment Facilities rvsd 07202023
- 06e. Consent for Redisclosure Multiple Tx Facilitiesrvsd 07202023
- 07. Client Rights rvsd 08122021
- 08. Complaint Grievance and Appeal Procedure rsvd 08122021
- 09. Charitable Choice Disclosure rsvd 08122021
- 10. LCDAC GPRA instructions and process rvsd
- 10A. LCDAC GPRA Follow Up Acknowledgement Signature Page
- 11. Buprenorphine medication paperwork and procedures
- 11A. LCDAC Request for Bup Medication form
- 11B. LGH Addiction Medicine Emergency Referrals Procedure
- 12. Ganse Apothocary and LGH Convenience Pharmacy Paperwork Procedures
- 13. Methadone Maintenance Paperwork Procedures to Request Funding Approval_
- 14. Continued Stay Request (002)
- 15. Request for MAT Funding Approval Outpatient-Inpatient