I acknowledge that on the date listed above that I have read and do fully understand that violation of any stipulation indicated below will result in a referral to an external provider or immediate discharge from treatment.
- Fully attend all scheduled groups and or individual counseling sessions
- Make contact with primary therapist and schedule counseling services
- Comply with treatment plan goals
- Comply with Medication Assisted Treatment Services
- Indicate Compliance through Urine Drug Screens