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Get Follow Up Treatment Report Form - Weld County District Attorney

TREATMENT in order to have the possibility of additional support reviewed. * A SEPARATE AND COMPLETE REPORT must be submitted for each family member in treatment. * Illegible or incomplete forms will slow processing. * Mental health providers should keep copies of this form on file, and should not expect notices concerning the submission of reports. Client Name: DOB: Related Client Name(s): Therapist(s): Clinical Supervisor: 1. Number of Sessions to Date: Individual Other Family Group Exp.

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