Attachment 10 - Treatment Program Progress Report for Parole Form 6.30.25.pdf

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Attached to
Contract RFP/SC-SBE NJ|25-PROS1-140939
Contract number
25-PROS1-140939
Issued by
New Jersey

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Document Summary

This is a Substance Use Disorder Treatment Program Progress Report for Parole Form (SUD010118) issued by the New Jersey Department of Corrections, Office of Substance Abuse Programming and Addiction Services. The form is associated with contract reference 25DPP01102 T1464 for Substance Abuse Services and serves as Attachment 10 to that contract. The document is designed for use across the state's correctional facilities to monitor and document individual client progress in substance use disorder treatment programs.

The form functions as a clinical progress assessment tool that tracks client participation and outcomes across two primary treatment modalities: residential care (short-term and long-term options) and outpatient care (intensive outpatient and standard outpatient). Counselors complete the form by documenting client identification information, admission and discharge dates, services attended, and progress ratings across seven behavioral and treatment-related criteria using a three-point scale (3=Exceptional, 2=Acceptable, 1=Requires Improvement). These criteria include acknowledgment of substance use disorder history, motivation to change, treatment compliance, attendance, assignment completion, social behavior, and group participation. The form requires signature authorization by both the SUD Program Counselor and SUD Program Supervisor, establishing accountability for treatment monitoring and parole-related decision-making.

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SUD010118

New Jersey Department of Corrections Office of Substance Abuse Programming and Addiction Services

Substance Use Disorder Treatment Program Progress Report for Parole

Location: EMCF SWSP Level of Care Residential

Short Term (STR) Long Term (LTR)

One level of care per form

Outpatient Intensive Outpatient (IOP) Outpatient (OP)

One level of care per form

Client Name: SBI# INM#

SUD Counselor:

Date of Admission:

Anticipated Date of Discharge: Date of Discharge:

List of Services attending/attended

3 – Exceptional; 2-Acceptable; 1-Requires Improvement

3 2 1 Please check all that apply Acknowledges history of substance use disorder Appears motivated to change behaviors (addictive, criminal, etc.)

Compliant with treatment expectations Attends treatment services as required Completes treatment assignments on time Exhibits appropriate social behaviors Active participation in groups

Brief Description of Progress:

SUD Program Counselor’s Signature: Date:

SUD Program Supervisor’s Signature: Date:

25DPP01102 T1464 Substance Abuse Services Attachment 10 - Treatment Program Progress Report for Parole Form

File details come from the government source that posted it. Updated .