Substance Use Forms

• Best Practice Discharge Planning Checklist (DOC)
• Discharge Management Plan (Template) (DOC)
• Certified Recovery Specialist Authorization Request/Discharge Form (PDF)
• Substance Use Disorder IOP Authorization Request and Discharge Form (PDF)
• Substance Use Out-of-Network Prior Authorization Request Form (PDF)
• Targeted Case Management (TCM) Substance Use Disorder (SUD) Authorization Request Form (PDF)