Graduate Check-in
Resident Name
First Name
Last Name
Did you attend a 12 Step meeting this week?
*
YES
NO
Meeting Name
*
Date
*
-
Month
-
Day
Year
Date
Time
*
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10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
*
Date
*
-
Month
-
Day
Year
Date
Time
*
1
2
3
4
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9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
Date
-
Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
Date
-
Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
Date
-
Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
Date
-
Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Add a meeting
YES
Meeting Name
Date
-
Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Who is your Sponsor?
Met with Sponsor?
YES
NO
When?
-
Month
-
Day
Year
Date
What Step are you on?
*
Any transition plans?
YES
NO
Describe the plans:
Requesting Time Off?
*
YES
NO
When, where and purpose?
Are you current on your fees?
*
YES
NO
N/A
Other notes:
House and maintenance issues etc.
Save
Submit
Should be Empty: