To document a variety of information specific to each client and necessary as a measure to maintain consistent client records, various program forms will be utilized.                

A.     Client File Checklist.  This will be entered in the client file on date of

admission by staff in charge of data coordinating.  Each time client information is inserted in the file, the data coordinator will enter the information on the Client File Checklist.  The Primary Counselor will monitor the checklist of each file on a monthly basis and give a summary of their clients files to the Program Coordinator which shall serve as mechanisms to assure client files are kept up to date.  

B.     Case Management Review.  The Case Management Review will be entered 

in each client file by the data coordinator within ten (10) days of the clients discharge.  The Case Management Review will be completed by staff members other than the Primary Counselor assigned to the case within
thirty (30) days of the client being discharged from the program.  Completed copies will be given to the
Primary Counselor of the case and the Treatment Coordinator.  Reviews will be discussed in monthly staff meetings and a summary review process submitted to the Advisory Board for review.   

C.     Financial Statements.  When applicable, will be completed upon admission and entered in client file.  

D.    Linen Issuance Form.  Upon admission client will be given articles to be used while in treatment and will
list items brought with them.  Clients will then sign this form designating receipt of items and of the list of
 items brought with them.  Data Coordinator will enter form into client file.   

E.     Consent to Follow-up.  Clients completing the program will have a follow-up review at least three (3) times proceeding treatment.  Upon admission client will be asked to sign this form giving InterTribal permission to complete this process either by mail, telephone contact, or through a personal interview.  

F.      Contract for Treatment.  During client orientation clients will be read the Contract for Treatment and be asked to sign this contract which states their intentions for treatment.  A copy will be given to the client and
the original entered into the client file.   

G.    Food Stamp Release Form.  Upon admission client will have explained to them the process of utilizing the food stamp program while a resident at the Center.  If a client’s family is currently utilizing food stamps such will be noted on the form and request for food stamps will not be made.  The Food Stamps Release form will be inserted in the clients file at admission.

H.    Release of Confidential.  Upon admission clients will be informed of their right to confidentiality and the
need for releases to anyone needing acknowledgement that this person is in treatment.  After proper completion of the form it will be inserted in client file.  Specific irrevocable release will be used as needed for the court system.  

I.       Consent to Follow-up Agency.  Prior to discharge clients will be informed of the programs desire to do a follow-up to the agency to which they are being referred for aftercare.  This consent fives permission to do so for a period of one (1) year.   

J.      Program Discharge.  Upon discharge staff on duty will complete this form disignat8ing all client forms
   are completed, agency belongings have been returned and the client is ready to leave the Center.  

K.    Follow-up Reports.  Follow-up on clients will be completed on a regular basis and filed in the client file as completed.   

Record Storage and Retention.  Closed records are to be retained by the program for at least ten (10) years from the late date of contact between the program and client.  After this period of time has elapsed, the record will be destroyed in a manner which complies with state and federal regulations.  

Prior to destruction a notation will be made on the client card file stating date of destruction.  The client card file will
be kept at the program site.