• SA IOP/SUCM Signature Page

    SA IOP/SUCM Signature Page

  • I attest to verbal consent for all admission documentation at the time of my assessment. My signature now further attest that I have received, understood, and in agreement with the following forms reviewed with me and explained further within the IOP Client Handbook.

  • Admission Documents:

  • RCCCS/RCRS Freedom of Choice to Request Services - 1st Intake Doc

    RCCCS/RCRS Notification of Human Rights - 2nd Intake Doc

    RCCCS/RCRS Orientation Checklist - 3rd Intake Doc

    RCCCS/RCRS Release of Liability Waiver - 4th Intake Doc

  • Releases of Information:

  • Release of Information – Primary Care Physician (PCP) and/or other Medical Providers

    Release of Information – Psychiatrist Release of Information – Therapist

    Release of Information - Other Providers (i.e., Treatment Centers)

    Release of Information - Supportive Housing

    Release of Information - MAT Practitioner

    Release of Information - Emergency Contact

    Release of Information – Probation & Parole

  • Treatment:

  • SUS Individualized Service Plan (ISP) Initial/Comprehensive/90 Day

    Quarterly Reports

    Relapse Prevention Plan

    Overdose Safety Plan

    Safety Plan

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  • SA IOP Drug Testing Informed Consent Form

  • At River City Comprehensive Counseling, we endorse the American Society of Addiction Medicine belief that addiction is a chronic relapsing disease of brain reward, motivation, and memory that is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. The inherent psychological defenses and dysfunctional thinking patterns caused by substance use disorders often influence individuals to misreport information.

    The River City Substance Abuse Intensive Outpatient Treatment Program includes random drug testing as a foundational component to maintain the integrity of our clinical therapeutic environment. At River City, our primary screening method is CLIA-waived urine analysis Point-of-Care tests utilized to monitor the accuracy of participant’s self-reports. At River City, we believe that change is possible but first requires self-honesty, acceptance, and engagement in the therapeutic treatment process. These test results are confidential and protected by federal statute 42 CFR Part II. To confirm accuracy of results, River City is contracted with Scientia Diagnostics (SDX) and/or Lab Corp. to send specimens for definitive confirmation testing.

  • , understand that drug screening is a foundational component

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