form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	patient_name	Patient Name	text	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	patient_dob	Date of Birth	date	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	program_name	Program/Facility Name	text	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	purpose_of_disclosure	Purpose of Disclosure	select	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	recipient_name	Information Will Be Disclosed To	text	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	recipient_address	Recipient Address	textarea	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	information_to_disclose	Information to be Disclosed	checkbox_group	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	disclosure_start_date	Consent Effective Date	date	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	disclosure_end_date	Consent Expiration Date	date	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	right_to_revoke	I understand I may revoke this consent at any time	checkbox	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	prohibition_notice	I understand this information is protected by federal law and cannot be re-disclosed without my consent	checkbox	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	voluntary_consent	This consent is voluntary and I have not been conditioned on signing	checkbox	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	patient_signature	Patient Signature	signature	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	signature_date	Date Signed	date	required
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	witness_name	Witness Name	text	
form	Consent for SUD Treatment Disclosure (42 CFR Part 2)	compliance	witness_signature	Witness Signature	signature	
form	Phase Advancement Request Form	operations	resident_id	Resident ID	hidden	required
form	Phase Advancement Request Form	operations	current_phase	Current Phase	select	required
form	Phase Advancement Request Form	operations	requested_phase	Requested Phase	select	required
form	Phase Advancement Request Form	operations	time_in_current_phase	Weeks in Current Phase	number	required
form	Phase Advancement Request Form	operations	meeting_attendance	Recovery Meetings Attended (last 30 days)	number	required
form	Phase Advancement Request Form	operations	employment_status	Employment Status	select	required
form	Phase Advancement Request Form	operations	community_service_hours	Community Service Hours (last 30 days)	number	
form	Phase Advancement Request Form	operations	ua_results_clean	All UA results clean in current phase	checkbox	required
form	Phase Advancement Request Form	operations	house_duties_compliant	Compliant with house duties	checkbox	required
form	Phase Advancement Request Form	operations	self_assessment	Self-Assessment: Why I'm ready to advance	textarea	required
form	Phase Advancement Request Form	operations	goals_for_next_phase	Goals for Next Phase	textarea	required
form	Phase Advancement Request Form	operations	challenges_addressed	Challenges I've Addressed	textarea	
form	Phase Advancement Request Form	operations	house_manager_endorsement	House Manager Endorses Advancement	checkbox	required
form	Phase Advancement Request Form	operations	house_manager_comments	House Manager Comments	textarea	
form	Residential Intake Form	onboarding	full_name	Full Legal Name	text	required
form	Residential Intake Form	onboarding	preferred_name	Preferred Name	text	
form	Residential Intake Form	onboarding	date_of_birth	Date of Birth	date	required
form	Residential Intake Form	onboarding	gender	Gender Identity	select	required
form	Residential Intake Form	onboarding	phone	Phone Number	phone	required
form	Residential Intake Form	onboarding	email	Email Address	email	
form	Residential Intake Form	onboarding	emergency_contact_name	Emergency Contact Name	text	required
form	Residential Intake Form	onboarding	emergency_contact_phone	Emergency Contact Phone	phone	required
form	Residential Intake Form	onboarding	emergency_contact_relationship	Relationship	text	required
form	Residential Intake Form	onboarding	referral_source	How were you referred?	select	required
form	Residential Intake Form	onboarding	referral_contact	Referral Contact Name	text	
form	Residential Intake Form	onboarding	insurance_provider	Insurance Provider	text	
form	Residential Intake Form	onboarding	insurance_id	Insurance ID	text	
form	Residential Intake Form	onboarding	ahcccs_id	AHCCCS ID (if applicable)	text	
form	Residential Intake Form	onboarding	medical_conditions	Current Medical Conditions	textarea	
form	Residential Intake Form	onboarding	current_medications	Current Medications	textarea	
form	Residential Intake Form	onboarding	allergies	Known Allergies	textarea	
form	Residential Intake Form	onboarding	substance_history	Substance Use History (brief)	textarea	
form	Residential Intake Form	onboarding	sobriety_date	Sobriety/Clean Date	date	
form	Residential Intake Form	onboarding	previous_treatment	Previous Treatment Programs	textarea	
form	Residential Intake Form	onboarding	program_preference	Preferred Program Level	select	required
form	Residential Intake Form	onboarding	move_in_date	Requested Move-In Date	date	required
form	Residential Intake Form	onboarding	length_of_stay	Anticipated Length of Stay	select	
form	Residential Intake Form	onboarding	house_rules_acknowledged	I acknowledge and agree to house rules	checkbox	required
form	Residential Intake Form	onboarding	consent_to_treatment	I consent to recovery support services	checkbox	required
form	Residential Intake Form	onboarding	financial_responsibility	I understand my financial responsibilities	checkbox	required