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Substance Abuse Partial Hospitalization Program (PHP) (All information requested on this form must be complete. Missing data may result in authorization delay.) PLEASE CHECK IF INITIAL OR CONCURRENT
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12-121 11-14 substance abuse refers to a specific form or report used to document instances of substance abuse within an organization.
Employers and organizations that have employees or members who have engaged in substance abuse are required to file the 12-121 11-14 substance abuse report.
The 12-121 11-14 substance abuse form typically requires information about the individual involved, the type of substance abuse, any actions taken by the organization, and any supporting documentation.
The purpose of 12-121 11-14 substance abuse reporting is to track instances of substance abuse within an organization and take appropriate actions to address the issue.
Information such as the name of the individual involved, the date of the incident, the type of substance abuse, any witnesses, and any actions taken by the organization must be reported on the 12-121 11-14 substance abuse form.
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