SAIL/AODA Forms
Community Services Branch
ADD Direct Staff Sheet - New
ADD Indirect Staff Sheet - New
Notification of Death Form
Notification of Death Form - Fillable
WIser Choice/ATR
Clinical treatment providers
Bus Ticket Treatment Verification Form
Client Sign In Sheet (Sample)
Continuation SAR - Fillable - New
RSS Service Authorization Requesting Form - New
Service Authorization Request (SAR) - Fillable - New
Transfer SAR - Fillable - New
Service Authorization form to request RSC Services and ASAM to support RSC service request
WIser Choice Discharge Form (Clinical / RSC), and Discharge Code Guidelines
RSC/CMASS providers
GPRA Client Incentive Form
RSC Ancillary Provider Referral Form - Fillable (to inform providers of referral)
WIser Choice Mass Discharge Form (CMASS)
Mental Health
SAIL Brochure and Referral Instructions
SAIL Consent Forms (must accompany Referral Form)
SAIL Treatment Consent Form (must accompany Referral Form) - New
Privacy Practices - New
SAIL Referral Form
SAIL Referral Form - Fillable (to print and send to SAIL)
Case Managers
SAIL Prior Authorization Form - Fillable (to print and send to SAIL)
SAIL Crisis Case Management Prior Authorization Form - New
SAIL RAP (Registration and Assessment Packet) Form
SAIL BPRS (Brief Psychiatric Rating Scale) Form
SAIL RFS (Role Functioning Scale) Form
Agreement To Repay SAM Funds Form - New
SAM Request Form - New
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