Participant Resources

Participant Forms

• • Progress Evaluation (PE)

• • Work Performance Evaluation (WPE)

• • Notice of address/employer change 

• • Short Term Medications

• • Medication Management Evaluation

• • Consent to Release Confidential Information to Third Party

• • Consent to Release Confidential Information for Facilitator/Co-Facilitator

• • Consent to Release Confidential Information for Individual Therapy

• • Consent to Release Confidential Information for Employer

• Consent to Release Confidential Information to Alternative Program

Links

• • IPN Participant Orientation Course

• • Frequently Asked Questions

January 2020

Post Test 33—Connecting the Dots

Objectives:

1. To examine the relationship between alcohol/drug use and life consequences

You must score a 70% or above on the post test to receive a continuing education credit via-Cebroker.com.

February 2020

Post Test 34—Slippery People, Places and Things

Objectives:
1. To examine the relationship between particular situations and relapse risk
2. To identify “slippery” people, places, and things that are personally high risk
3. To plan action steps to avoid or handle personal high-risk situations