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Vermont Recovery Center Network – Demonstrating Solutions
Your Name: ____________________________ Date:__________________
Time Shift Started: _________ Time Shift Finished: __________
Number of people at the meeting: (if during your shift)
Name of meeting_____________________________
Walk in visitors: Total visitors during shift ________
_____________________________________________________Number of visitors during shift
_______Explanation of Center [welcome visitor, introduce, show around & offer materials]
_______Referrals to 12 step meetings
_______Referrals to other support groups (what group?)_____________________________
_______Crisis Interventions – made referrals to: ___________________________________
_______Recovery support [conversation/ interaction - engage and refer when appropriate]
Referrals to local organizations: _______Substance abuse treatment / counseling
_______Mental health treatment / counseling
_______Other addiction services [gambling, overeating]
_______Medical needs
_______Housing
_______Employment
_______Financial assistance
_______Education
_______Parenting support / childcare
_______Other
Incoming phone calls: Total calls during shift__________
________________________________Explanation of Center [engage caller and invite to center]
________________________________Recovery support for caller
[in providing recovery support - engage and refer when appropriate - see list below]
_______Crisis calls – made referrals to: ___________________________________________
_______Referrals to 12 step meetings
_______Referrals to other support groups (what group?)_____________________________
Referrals to local organizations: _______Substance abuse treatment / counseling
_______Mental health treatment / counseling
_______Other addiction services [gambling, overeating]
_______Medical needs
_______Housing
_______Employment
_______Financial assistance
_______Education
_______Parenting support / childcare
_______Other
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