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04/12/2026Click to Sign
Grant Type
3 Month Followup
6 Month Followup
Discharge Interview
A.1. Refused
A.2.
A.3
A.3.a
A.4.
A.5.
A.5.a
A.6.
New Field
A.7.
A.8
A.9
A.9.A - refused
A.9.b
A.9.c
A.10
A.11
B1.B
B.2
B.3
B.4
B.5
B.6
B.7
B.8
B.9
B.10
B.10 a
New Field
B.10 a
New Field
New Field
B.11
B.11a.
B.11b
12.Modality
12. Case Management Services
12. Medical Services
12. After care services
12. Treatment Services
12. Education Services
12. Recovery Support Services
C.1
C.2
D.1
D.2
D.3
D.4
D.5
E.1 Legal
E. 2 Legal
E.3 Legal
E. 4 Legal
F.1 Mental and physical health problems and treatment-recovery
F.1 Mental and physical health problems and treatment-recovery - Refused
F.3
F.4
F.5
F.5a
New Field
G. Social Contentedness 1.
rG. Social Contentedness 2.
G. Social Contentedness 3.
G. Social Contentedness 4.
x

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