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Supervision Forms

Vendors

Travel Request

Monthly Treatment Report (.pdf)

Orientation to Supervision

 

Monthly Treatment Report (WordPerfect) (Fillable)

 [Right Click (Save Link or Target As)]

All 2005 Blanket Purchase Agreements

Invoice (Excel Version)

2006 Blanket Purchase Agreements

Invoice Substance Abuse

Invoice Sex Offender

Invoice Mental Health

Invoice Residential Treatment

To Download a template right click the link and select Save Link or Save Target As in the popup menu.Save the file to your computer. Then each time you prepare an invoice open the downloaded file on your computer and immediately save to a new file before entering any data into the spreadsheet. This will keep the template on your computer from being changed. Saving in this way will allow you to prepare future invoices without having to download once again.

 

 

Monthly Supervision Report (St. Louis)

Monthly Supervision Report (Cape Girardeau)

 

 

    Releases of Information

bulletPROB11B AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION TO TREATMENT PROVIDER
bulletPROB11G Authorization to Release Information (Private Person or Organization (.pdf version)
bulletPROB11G Authorization to Release Information (Private Person or Organization (WordPerfect version - right click - save as)
bulletPROB11H Authorization to Release Government Information (.pdf version)
bulletPROB11H Authorization to Release Government Information (WordPerfect version - right click - save as)
bulletPROB11I Authorization to Release Confidential Information Mental Health Treatment Programs (.pdf version)
bulletPROB11I Authorization to Release Confidential Information Mental Health Treatment Programs (WordPerfect version - right click - save as)

Financial

Net Worth Statement PROB48

Request for Net Worth Statement Financial Records PROB48A

Instructions for Completing Monthly Cash Flow Statement PROB48B

Request for Monthly Cash Flow Statement PROB48C

Declaration of Net Worth and Cash Flow Statements PROB48D

Customer Consent for Authorization for Access to Financial Records Presentence  PROB48E

Instructions for Completing Net Worth Short Form PROB48EZ

Request for Self-Employment Records PROB48F

Financial Worksheet Lump Sum Determination PROB48G

Notice to U.S. Attorney's Office PROB48H

Customer Consent for Authorization for Access to Financial Records Supervision PROB48I

Monthly Money Management Work Sheet