Client Forms & Instructions

Scroll down for Prevention, Fiscal and Miscellaneous information.

  1. Prevention
  2. Fiscal
  3. Universal
  1. 01. Admissions Form
  2. 02. Discharge Form
  3. 04. Paperwork Procedures WMS, Residential, Extending, Transfer, DC
  4. 04A. For the Community Based Contracted Providers Procedures to Request Funding for Residential Placement LOC
  5. 06. Consent to Release Information rvsd 07202023
  6. 06a. Consent for Re-Disclosure rvsd 07202023
  7. 06b. Consent for Lancaster County Treatment Courts rvsd 07202023
  8. 06c. Consent for LCP Pre-Parole and D2D Referrals rvsd 010926
  9. 06d. Consent for Multiple Treatment Facilities rvsd 01122026
  10. 06e. Consent for Redisclosure Multiple Tx Facilities rvsd 01122026
  11. 07. Client Rights rvsd 08122021
  12. 08. Complaint Grievance and Appeal Procedure rsvd 08122021
  13. 09. Charitable Choice Disclosure rsvd 08122021
  14. 10. LCDAC SUPRT Instruction Guide
  15. 10A. LCDAC SUPRT Cover Sheet
  16. 11. Buprenorphine medication paperwork and procedures
  17. 11A. LCDAC Request for Bup Medication form
  18. 11B. LGH Addiction Medicine Emergency Referrals Procedure
  19. 12. Ganse Apothocary and LGH Convenience Pharmacy Paperwork Procedures
  20. 13. Methadone Maintenance Paperwork Procedures to Request Funding Approval_
  21. 14. Continued Stay Request (002)
  22. 15. Request for MAT Funding Approval Outpatient-Inpatient

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