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AA - NA Attendance - Adult Probation

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AA - NA Attendance - Adult Probation

Revised 5/01 AA - NA Attendance DEFENDANT’S NAME OFFICER’S NAME The following record is a true representation of the AA/NA meeting(s) that I have attended.

http://www.adultprobation.net/files/aa.pdf

Date added: October 21, 2011 - Views: 1033

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Meeting Attendance Verification - aa-shreveport

Meeting Attendance Verification Name: _____ Date/Time:_____/_____ Circle one: (AA, NA, CA) Meeting: _____ Location:_____

http://aa-shreveport.org/uploads/MeetingVerificationForm.pdf

Date added: February 16, 2013 - Views: 162

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AA Attendance Record - United States Probation and Pretrial ...

AA Attendance Record It is your responsibility to attend at least AA meetings per week. This form is to be brought back to the U.S. Probation Office each week that you are in treatment.

http://www.mssp.uscourts.gov/Forms/AAMeet.pdf

Date added: December 27, 2012 - Views: 186

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ATTENDANCE FORM FOR ALCOHOLICS/NARCOTICS ANONYMOUS MEETINGS

ATTENDANCE FORM FOR ALCOHOLICS/NARCOTICS ANONYMOUS MEETINGS NAME: SUPERVISION OFFICER: The above captioned individual is required by his supervision conditions to attend Alcoholics Anonymous meetings.

http://www.co.grayson.tx.us/users/CSCD/aa_na_attendance_form.pdf

Date added: April 28, 2014 - Views: 1

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ARIZONA STATE BOARD OF NURSING

arizona state board of nursing 4747 north 7th street, suite 200 phoenix, arizona 85014-3655 (602) 771-7865 fax (602) 771-7882 aa/na attendance report

http://www.azbn.gov/documents/cando/CANDO-FORM-AA-NA-ATTENDANCE.pdf

Date added: February 22, 2012 - Views: 36

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Attendance Form for Alcoholics/Narcotics Anonymous or ...

Attendance Form for Alcoholics/Narcotics Anonymous or Independent Outpatient Meetings. Full Name Department Job Title Supervisor University ID The above named individual is required to attend these meetings.

http://www.drexel.edu/hr/resources/policies/dupolicies/hr11/~/media/Files/hr/forms/AAOutpatientDU.ashx

Date added: March 28, 2012 - Views: 100

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Attendance Record for Alcoholics or Narcotics Anonymous ...

Attendance Record for Alcoholics or Narcotics Anonymous Meeting/Alcohol Awareness Class Name: _____ Case No. _____ The above named individual is required by the terms of his Occupational Driver’s License to attend Alcoholics/Narcotics Anonymous

http://www.co.denton.tx.us/dept/forms/Attendance_Record_forM.pdf

Date added: October 8, 2011 - Views: 237

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Recovery Program Meeting Attendance Log - KYLAP

General: AA-Alcoholics Anonymous Specific: ... NA-Narcotics Anonymous RECOVERY PROGRAM MEETING ATTENDANCE LOG *Types of meeting (indicate both general and specific type): Title: Recovery Program Meeting Attendance Log.xls Author: hprather

http://www.kylap.org/files/Recovery%20Program%20Meeting%20Attendance%20Log.pdf

Date added: February 17, 2012 - Views: 346

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12 Step Meeting Attendance Sheet AA/NA/CA/DRA/GA

12 Step Meeting Attendance Sheet AA/NA/CA/DRA/GA Name: _____ Phase :_____ Week of: _____ Date Group Chairperson Time Signature: _____ Date: _____ * Phase I & II ...

http://www.co.jackson.mi.us/jacksoncounty/county_courts/honorable_susan_beebe/recovery_court/uploads/12_Step_Meeting_Attendance_Sheet.pdf

Date added: October 25, 2012 - Views: 179

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AA/NA/CA Attendance Verification - Gallipolis, Ohio

A.A./N.A./C.A. ATTENDANCE VERIFICATION NAME _____ IS TO ATTEND A MINUMUM OF _____ MEETINGS PER WEEK Directions : Fill in date & time then at the beginning of meeting, hand this form to chairperson or secretary so at the

http://www.cityofgallipolis.com/gallipolis/judicial_system/uploads/AANACA_Attendance_Verification.pdf

Date added: October 25, 2012 - Views: 80

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TO WHOM IT MAY CONCERN - Aspen Counseling

AA/NA neither endorses nor opposes any causes or organizations. PROOF OF ATTENDANCE AT AA/NA MEETINGS DATE NAME AND LOCATION OF GROUP NAME OF SIGNER TELEPHONE # Title: TO WHOM IT MAY CONCERN: Created Date:

http://www.aspen-counseling.com/documents/aanaproofofattendance.pdf

Date added: January 28, 2012 - Views: 109

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ARIZONA STATE BOARD OF NURSING 4747 NORTH 7TH STREET, SUITE ...

MONITORING - AA/NA ATTENDANCE REPORT NAME: TIME PERIOD COVERED BY THE REPORT: FROM:_____TO:_____ SPONSOR’S NAME: SPONSOR ... Below, and on the other side of this form, LIST ONLY AA/NA/CA meetings, the date you attended, and

https://www.azbn.gov/documents/monitoring/MONITOR-FORM-AA-NA-CNA.pdf

Date added: January 5, 2013 - Views: 3

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12-STEP MEETING ATTENDANCE SHEET - sks

ca, aa, na chairperson sign or initial required: sponsor comments on step work/progress/ other: ... 12-step meeting attendance sheet author: mary messinger created date: 10/26/2012 3:18:20 pm ...

http://nmbon.sks.com/uploads/FileLinks/d88b43be87804a6c942e2e0aa67ef3ad/12_Step_Meeting_Attendance_Oct12.pdf

Date added: May 3, 2013 - Views: 112

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ON-LINE MEETING FORM - Narcotics Anonymous

Please return to: NA World Services, PO Box 9999, Van Nuys, CA 91409 -9099 USA This form is also available on our website – www.na.or g. ON-LINE MEETING FORM

http://www.na.org/?ID=OnlineMeetingForms.pdf

Date added: May 12, 2012 - Views: 23

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Verification of Meeting Attendance (AA, NA, MA)

Microsoft Word - Verification of Meeting Attendance (AA, NA, MA) Author: btwhite Created Date: 8/21/2012 11:23:43 AM ...

http://students.ucsd.edu/_files/student-conduct/osc-meeting-verification-form.pdf

Date added: May 6, 2013 - Views: 19

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DATE GROUP CHAIRPERSON/PHONE # OPEN/CLOSED MEETING

AA Hotline 248.541.6565 AA Booklet Information 248.541.7490 ... Please do not sign this form until the completion of the meeting. Your cooperation in this matter is appreciated. ... Microsoft Word - AA NA Attendance Record Author:

http://www.cityofsouthfield.com/Portals/0/docs/46th%20DC/AA%20NA%20Attendance%20Record.pdf

Date added: October 31, 2011 - Views: 94

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AA/NA/GA VERIFICATION SHEET AFTER THE MEETING HAS ENDED

AA/NA/GA VERIFICATION SHEET Due to your special condition(s), you are required to attend one (or ____ ) AA, NA or GA meetings per week. You must have the secretary of the meeting sign this form AFTER THE

http://www.rip.uscourts.gov/rip/supervision/supervisionforms/AANAform.pdf

Date added: February 3, 2012 - Views: 284

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ATTENDING AA/NA MEETINGS AND ABSTINENCE FROM ALCOHOL AND ...

Table 4.3 Attendance of AA/NA Meetings and Abstinence from ... Alcoholics Anonymous and Narcotics Anonymous meetings, rather than the entire ... AA/NA meetings and abstinence form alcohol and/or drugs within the demographics of

http://csus-dspace.calstate.edu/bitstream/handle/10211.9/1642/Thesis.pdf?sequence=1

Date added: August 12, 2013 - Views: 8

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SELF-HELP ATTENDANCE VERIFICATION - HPRP

Monthly Attendance Verification - Self-Help Meetings 1 of 1 www.hprp.org ... This form is used to verify that I have attended the following self-help group meetings (AA, NA, Caduceus, Al-Anon, Nar-Anon, etc.)

http://www.hprp.org/documents/Self-Help%20Attendance%20Verification.pdf

Date added: May 10, 2013 - Views: 46

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SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL ...

sdsc crm-190 (rev. 12/13) aa/na/ca/ma meeting attendance sheet superior court of california, county of san diego central division, county courthouse, 220 w. broadway, san diego, ca 92101

http://www.sdcourt.ca.gov/pls/portal/docs/PAGE/SDCOURT/GENERALINFORMATION/FORMS/CRIMINALFORMS/CRM190.PDF

Date added: January 27, 2014 - Views: 5

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S.A.R.P.H. SUPPORT GROUP ATTENDANCE SHEET

S.A.R.P.H. SUPPORT GROUP ATTENDANCE SHEET NAME:_____ Due by the 10th of each month. AA/NA, ALANON/ACOA, ETC

http://www.sarph.org/documents/Attend_sheet_no_SSN.pdf

Date added: November 24, 2011 - Views: 50

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Miami-Dade County Drug Court Program

Miami-Dade County Drug Court Program . DEFENDANT’S PROOF OF 12 STEP PROGRAM (NA/AA) ATTENDANCE . As a condition of my participation in the Miami-Dade Drug Court Program, I,

http://www.friendsofthedrugcourt.org/fodc/images/stories/meeting%20attendance%20sheet.pdf

Date added: March 7, 2012 - Views: 25

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County of Santa Clara - SCCGOV

Please return this form to the client at the close of the meeting. AA: (408) 374-8511 [www.aasanjose.org]; NA: (408) 998-4200 ... * You are to provide proof of meeting attendance during the first week of each new month. You can

http://www.sccgov.org/sites/pretrial/Services/Forms/Documents/AA-NA%20Attendance%20of%20Meeting%20Form.pdf

Date added: May 13, 2013 - Views: 5

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AA/NA/SUPPORT GROUP OR AFTERCARE MEETINGS REPORT

aa/na/support group or aftercare meetings report • nurse’s name: • group name: • group location: • date attended:

http://www.arsbn.arkansas.gov/forms/Documents/meetings_report.pdf

Date added: March 5, 2012 - Views: 15

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Attendance at Narcotics Anonymous and Alcoholics Anonymous ...

Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment

http://www.orange-papers.org/Gossop_et_al_2007_Attendance_and_outcomes.pdf

Date added: March 28, 2012 - Views: 33

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Attendance Verification Sheet - Walker County, Texas

Attendance Verification Sheet _____ is to attend AA/NA meetings as ordered by the Judicial District Community Supervision and Corrections Department.

http://www.co.walker.tx.us/egov/apps/document/center.egov?path=doc&id=478&id2=381

Date added: May 3, 2013 - Views: 60

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United States District Court Probation Office District of ...

United States District Court Probation Office District of Wyoming NA/AA VERIFICATION OF ATTENDANCE Name: _____ Month: _____

http://www.wyp.uscourts.gov/forms/NA-AA-Verification-Form.pdf

Date added: June 13, 2012 - Views: 12

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Verification of Enrollment and Attendance (VOE) Form

Form CDD-104 Revised 1/2006 School Name County-District-Campus No. (If Applicable) Verification of Enrollment and Attendance (VOE) Form Planned Use of Data: To provide documentation of enrollment and attendance status to the Texas Department of Public Safety (DPS) for a

http://www.usdrivertraining.com/states/Texas/voe.pdf

Date added: November 6, 2011 - Views: 33

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Support Group Attendance Form

support group attendance form (please make sufficient copies for your use) participant: _____ reporting month(s)_____ no. of support groups [aa, na, ca, al-anon] mtgs per week: _____ no. of nurse support group mtgs. per week: _____ sunday: - saturday ...

http://www.oklahoma.gov/nursing/supgrp.pdf

Date added: August 10, 2013 - Views: 6

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12-STEP MEETING ATTENDANCE SHEET - sks

12-step meeting attendance sheet . to be submitted by the 15th of each month due . month/year_____name:_____license #: _____ date time of day ... type: ca, aa, na chairperson sign or initial . required: sponsor comments on step work/progress/ other:

http://nmbon.sks.com/uploads/FileLinks/d2be4887fe8948e7b95df0793ca4378a/DP_12_step_mtg_attendance_Nov11.pdf

Date added: May 14, 2013 - Views: 22

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TEXAS DEPARTMENT OF CRIMINAL JUSTICE PAROLE DIVISION

AA/NA or some form of substance abuse counseling : 3. Group counseling : 4. Access to religious services : 5. Mandatory house meetings : 6. Case management support through community referrals : 7. Medication monitoring : 8.

http://www.tdcj.state.tx.us/documents/parole/02.01.18_parole_policy.pdf

Date added: March 25, 2012 - Views: 1

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REP Meeting Attendance Forms Instructions

REP Meeting Attendance Forms ... (AA, NA) o Sponsor meetings o Group meetings (IOP, relapse prevention, aftercare or other treatment or group ... attending, have an AA group member or your sponsor sign the form verifying your participation.

http://www.southworthassociates.net/resources/monitoring/recovery-enhancement-program?download=65%3Arep-car-instuctions

Date added: February 16, 2014 - Views: 4

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generic meeting attendance sheet - Bing

ATTENDANCE FORM FOR ALCOHOLICS/NARCOTICS ANONYMOUS MEETINGS ... Free AA Meeting Attendance Sheet Den Meeting Attendance Sheet 12 Step Meeting Attendance Sheet. Title: generic meeting attendance sheet - Bing Created Date: 2/15/2014 8:47:46 PM ...

http://pdfsdir.com/download/generic-meeting-attendance-sheet.pdf

Date added: April 14, 2014 - Views: 10

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Louisiana State Board of Nursing

H. AA/NA attendance reported: Y N N/A . I. Any known alcohol or drug use: Y N N/A . J. Compliant with treatment: Y N K. Anticipated date of completion of ... Therapist/Counselor Report Form Author: BARBARA MORVANT

http://www.lsbn.state.la.us/Portals/1/Documents/rnp/TherapistReport.pdf

Date added: May 17, 2013 - Views: 4

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Boone County Drug Court Entry Questionnaire

program if I falsify an AA/NA attendance sheet or community services form. True False 21. If I relapse, I will be required to start Phase II ... Attendance will be required at 12-step meetings such as Narcotics Anonymous and Alcoholics Anonymous. The MINIMUM attendance requirement for the ...

http://www.courts.mo.gov/hosted/circuit13/documents/ASC_DCBNEManual.pdf

Date added: September 27, 2012 - Views: 14

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NAME REPORT FOR THE MONTH , 20

COMPLIANCE DIVISION NAME_____ REPORT FOR THE MONTH _____, 20_____ This form may be used to document your weekly attendance at AA/NA meetings.

http://www.msbn.state.ms.us/Documents/Compliance/AANA%20Calendar.pdf

Date added: September 24, 2013 - Views: 2

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Meeting attendance cards (CHITS) - NA Public Relations Website

Meeting attendance cards (CHITS) ... example where these form part of a Drug Treatment and Testing Order (DTTO). In accordance with our Traditions and with NA World Services suggested policy, and in the light of the positive experience of both AA and NA around the world, ...

http://na-pr.org/wp-content/uploads/2012/03/UKPI_Chits_Court_Cards_2005.pdf

Date added: October 25, 2012 - Views: 20

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Louisiana State Board of Nursing

J. AA/NA attendance reported: Y N N/A K. Any known alcohol or drug use: Y N N/A L. Compliant with treatment: Y N . M. Anticipated date of completion of ... Signature Date. Title: Psychiatrist/Addictionist Monthly Report Form Author: BARBARA MORVANT

http://www.lsbn.state.la.us/Portals/1/Documents/rnp/PsychiatristReport.pdf

Date added: May 17, 2013 - Views: 5

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POLICY AND OPERATING PROCEDURE SUPERSEDES

Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Secular Organizations for Sobriety (SOS), or any faith based support groups a minimum of two (2) times ... Continue weekly attendance at community-based support groups activities a

http://www.tdcj.state.tx.us/documents/parole/03.08.01_parole_policy.pdf

Date added: November 20, 2012 - Views: 3

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FUM083-Outpatient Substance Use Disorder Treatment Request Form

Use this form only to request group or individual therapy for substance use disorders. For any mental health treatment requests, ... Outside AA/NA Attendance* None 1-4/Week > 4/Week Sponsorship* Nome Temporary Permanent Skill ...

http://www.companionbenefitalternatives.com/UserFiles/File/Providers/Forms/FUM083-Outpatient%20Substance%20Use%20Disorder%20Treatment%20Request%20Form.pdf

Date added: November 8, 2013 - Views: 3

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Virginia Health Practitioners’ Monitoring Program Monthly ...

Monthly Group Attendance Report – Substance Use Disorder ... (Examples: AA, NA, CA, SA, Al-Anon, CODA, etc.) ... (Please fax this form to 804-828-5386 by the 10 th of the month. Thank you for your cooperation!) For Office Use Only:

http://www.dhp.virginia.gov/hpmp/forms/GroupAttendance_Monthly.pdf

Date added: December 1, 2012 - Views: 4

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PORT ORCHARD MUNICIPAL COURT

schedule of AA/ NA meetings in Kitsap County and reporting forms may be obtained at the ... proof of attendance filed with the Court on a court-approved form. DEFERRED PROSECUTION -- PROCEDURES:

http://www.cityofportorchard.us/docs/court/forms/form_9c.pdf

Date added: January 28, 2012 - Views: 16

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PROBATION MONTHLY REPORT - Oakland County, Michigan

which program and attach proof of attendance: AA/NA Meeting Treatment/Counseling How often do you attend? _____ ... Please sign below stating that all of the answers on this form are true to the best of your knowledge. Please mail to the above address (please include

http://www.oakgov.com/courts/dc48/Documents/Probation/Mthly_Reporting_050307.pdf

Date added: July 23, 2014 - Views: 1

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Recovery in NA is an ongoing process and members continue to ...

meeting AttendAnCe NA members find that regular meeting attendance helps ... to form relationships with other recovering addicts and ... Narcotics Anonymous is not affiliated with these organizations, ...

http://www.na.org/admin/include/spaw2/uploads/files/EN3127.pdf

Date added: January 29, 2012 - Views: 4

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How Effective Is AA and 12 Step Treatment?

AA, NA, or other 12 step groups are probably only a good fit for a minority of people with a drug or alcohol problem. ... because of the religious content of AA meetings. Court ordered AA attendance is a violation of

http://www.hamsnetwork.org/effective.pdf

Date added: February 8, 2014 - Views: 16

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WSC RESIDENTIAL SCREENING Form 8-06 - West Slope Casa

AA NA OTHER _____ ATTENDANCE: Regular or Sporadic *MEDICAL ISSUES: West Slope Casa Medical ... Microsoft Word - WSC RESIDENTIAL SCREENING Form 8-06.doc Author: sally Created Date:

http://www.westslopecasa.org/Documents/WSC%20RESIDENTIAL%20SCREENING%20Form%208-06.pdf

Date added: January 5, 2013 - Views: 7

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PEER ASSISTANCE PROGRAM OKLAHOMA BOARD OF NURSING 2901 N ...

SUPPORT GROUP ATTENDANCE FORM ... REPORTING MONTH: _____ # of mtgs. per Month AA, NA, CA, AL-ANON Day Support Group Type Location Date Time Signature (1st name, last initial) chairperson or facilitator Chairperson or Facilitator’s phone ...

http://www.ok.gov/nursing/opap2.pdf

Date added: January 5, 2013 - Views: 3

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aa meeting sign up sheet template - Bing

Reimbursement Form Sign Up Sheets Timesheet Template Vacation Tracker Work ... AA / NA MEETING ATTENDANCE SHEET NAME: ... A Simple Meeting Sign-in Template | Sign in Sheets signinsheets.com/sheets/a-simple-meeting-sign-in-template

http://pdfsdir.com/download/aa-meeting-sign-up-sheet-template.pdf

Date added: April 15, 2014 - Views: 9

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PRN Client Activity Report (CAR) Forms Instructions

83706), fax (208-323-9222), and/or email your monthly attendance form to the PRN office. Please be aware that a low meeting non-compliance letter will go ... o Mutual Support Groups (i.e. AA, NA or other 12 step) o Sponsor meetings o Group meetings (i.e. IOP, relapse prevention, ...

http://www.southworthassociates.net/resources/monitoring/physician-recovery-network?download=62%3Adoctor-car-instructions

Date added: February 4, 2014 - Views: 5

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ORDER PENDING ACCEPTANCE FOR DEFERRED PROSECUTION ORDERED ...

The defendant shall attend a minimum of two (2) 12-step self help group meetings (AA, NA, etc.) per week and provide written proof of such attendance to the court at each court hearing; 2. The defendant shall comply with all court orders including Orders of Release;

http://www.cityofportorchard.us/docs/court/forms/form_9e.pdf

Date added: May 17, 2013 - Views: 8