This behavior contract is in place to support goals identified on your treatment plan and correct conduct as set forth by Life Changes, Inc. The follow incidences have shown inconsistencies:

Moving forward, these actions WILL NOT BE TOLERATED IN ANY WAY SHAPE OR FORM. You are being asked to sign this behavioral contract and support will be provided to assist you in addressing your inconsistencies and infractions of program requirements.

Moving forward, these actions WILL NOT BE TOLERATED IN ANY WAY SHAPE OR FORM. You are being asked to sign this behavioral contract and support will be provided to assist you in addressing your inconsistencies and infractions of program requirements.

However, if these behaviors persist, the following actions may take place:

• With input and support from your medical care team and your health plan, you may be assessed for a higher level of care.
• Non-adherence to the behavioral contract will be noted in your case file and will be taken into consideration should you need respite services in the future.
• Continued violation of the code of conduct can and will result in law enforcement involvement

I, the undersigned, understand and agree to abide by these rules and regulations knowing that acting against these rules the consequences will escalate and may include permanent trespass from the facility.