11-Verification of Sex Offender Treatment Services Performed (Group).pdf
PDF 61 KB Posted
- Attached to
- RFP - Sex Offender Treatment Services for the Harris County Community Supervision & Corrections Department
- Solicitation number
- 25/0129
- Issued by
- Harris County, Texas
About this file
This is a verification form from the Harris County Community Supervision and Corrections Department for documenting sex offender group therapy participation. The form serves as an attendance record that contractors must use to verify service delivery when submitting invoices for payment to the department.
The form includes fields for session date, time, and group number, along with spaces for up to 10 participants to provide their printed names, tracer numbers, and signatures. A facilitator section at the bottom requires both printed name and signature verification. The form explicitly states that all original verification of service forms must be attached to invoices submitted for payment, indicating this document is part of a contractual payment verification process for therapeutic services provided to individuals under community supervision.
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Text version
HARRIS COUNTY COMMUNITY SUPERVISION AND CORRECTIONS DEPARTMENT
VERIFICATION OF SEX OFFENDER GROUP THERAPY PARTICIPATION
DATE OF SESSION: TIME: ______ GROUP NO. _____
PRINTED NAME & TRACER # SIGNATURE
1.____________________________________ _______________________________
2.____________________________________ _______________________________
3.____________________________________ ________________________________
4.____________________________________ ________________________________
5.____________________________________ ________________________________
6.____________________________________ ________________________________
7.____________________________________ _________________________________
8.____________________________________ _________________________________
9._____________________________________ _________________________________
10.____________________________________ __________________________________
(FACILITATOR’S PRINTED NAME AND SIGNATURE)
NOTE: PLEASE ATTACH ALL ORIGINAL VERIFICATION OF
SERVICE FORMS TO INVOICES SUBMITTED FOR PAYMENT.
File details come from the government source that posted it. Updated .