Forms

SAIL/AODA Forms

Community Services Branch

Notification of Death Form

Notification of Death Form - Fillable

WIser Choice/ATR

Clinical treatment providers

Bus Ticket Treatment Verification Form

Client Sign In Sheet (Sample) 

Service Authorization form to request RSC Services and ASAM to support RSC service request

WIser Choice Discharge Form (Clinical / RSC), and Discharge Code Guidelines

RSC/CMASS providers

Bus Ticket Treatment Verification Form

GPRA Client Incentive Form

RSC Ancillary Provider Referral Form - Fillable (to inform providers of referral)

WIser Choice Discharge Form (Clinical / RSC), and Discharge Code Guidelines

WIser Choice Mass Discharge Form (CMASS)

Mental Health

SAIL Brochure and Referral Instructions

SAIL Consent Forms (must accompany Referral Form)

SAIL Referral Form

SAIL Referral Form - Fillable (to print and send to SAIL)

SAIL Prior Authorization Form - Fillable (to print and send to SAIL)

SAIL RAP (Registration and Assessment Packet) Form

SAIL BPRS (Brief Psychiatric Rating Scale) Form

SAIL RFS (Role Functioning Scale) Form