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Appendix A: Prescreener
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Appendix B: Screener
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Appendix C: Client Contact Tracking
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Appendix D1: Initial Assessment - 90 Day Recall
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Appendix D2: Initial Assessment - 15 or 30 day recall
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Appendix E1: Prevention Plan Worksheet
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Appendix E2: Instructions for Prevention Plan Worksheet
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Appendix F1: Case Notes
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Appendix F2: Instructions for Case Notes
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Appendix G: Session Activities and Content
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Appendix H: Referral Tracking
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Appendix I1: Follow Up Assessment
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Appendix I2: Follow Up Assessment (Optional)
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Appendix J: Discharge
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Appendix K: Review of Client Record Checklist
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Appendix L: Folder Checklist (for Counselor)
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Appendix M: Client Survey Questionnaire
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Appendix N: Examples of Initial Interview Assessment Questions
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Appendix O: Screening for Alcohol Abuse; CAGE Questionnaire
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Appendix P: SAMISS Screener
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Appendix Q: CDQ Client Diagnostic Questionnaire
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Appendix R: Safety Checklist - Home and Community Visits
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Appendix S: Program Preparation Worksheet
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Appendix T1: Case Scenario for Carol
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Appendix T2: Prevention Plan Example for Carol
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Appendix U1: Case Scenario for Tony
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Appendix U2: Prevention Plan Example for Tony
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Appendix V: Worksheet on Developing SMART Objectives
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Appendix W: Client/Staff Boundaries & Ethical Guidelines
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Appendix X: A Modified Framework for Supervision: 8 Key Components
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Appendix Y: CRCS-PEMS Crosswalk
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