Get the free Intensive Supervision and Counseling Services, LLC is a small human services agency,...
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235 SOUTH STREET, SUITE A
FRONT ROYAL, VA 22630
Office: 5406360068
Fax: 540635.4006
CLIENT REFERRAL FORM
(PLEASE fill out ALL areas)
NAME:DOB:SOC. SEC.:RACE:GENDER:MaleFemaleTODAYS DATE:PARENTS/GUARDIANS:
ADDRESS:
PHONE:
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Start by entering your personal information, such as your name, date of birth, and contact details.
03
Provide information about your current situation, including your employment status, education, and living arrangements.
04
Answer questions about your history of drug or alcohol use, as well as any prior treatment or legal issues.
05
Describe your current support system, including family, friends, or other individuals who can help you during the program.
06
Provide information about your mental health, including any diagnosed conditions or medications you are currently taking.
07
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Who needs intensive supervision and counseling?
01
Intensive supervision and counseling is typically needed by individuals who meet certain criteria, such as:
02
- Those who have a history of substance abuse or addiction
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- Individuals who have experienced repeated legal issues related to substance abuse
04
- Those who show a high risk of relapse or non-compliance with traditional treatment methods
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- Individuals who require a more structured and intensive approach to address their substance abuse issues
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- People who have co-occurring mental health disorders along with substance abuse problems
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- Those who have not responded effectively to traditional outpatient treatment or less intensive interventions
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What is intensive supervision and counseling?
Intensive supervision and counseling is a structured program designed to provide close monitoring and support to individuals who require extra guidance, often in the context of rehabilitation or probation.
Who is required to file intensive supervision and counseling?
Individuals under certain legal or rehabilitation programs, such as probationers or parolees with specific conditions imposed by a court, are required to file for intensive supervision and counseling.
How to fill out intensive supervision and counseling?
To fill out intensive supervision and counseling, individuals must complete the designated forms provided by the supervising authority, ensuring all personal information, compliance details, and acknowledgment of the program's terms are correctly entered.
What is the purpose of intensive supervision and counseling?
The purpose of intensive supervision and counseling is to assist individuals in making positive life changes, reducing recidivism rates, and ensuring compliance with rehabilitation goals through frequent check-ins and support.
What information must be reported on intensive supervision and counseling?
Individuals must report personal identification details, progress in counseling sessions, compliance with program rules, and any changes in circumstances to the supervising authority.
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