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Participant Resources - Forms and Helpful Links

Participant Reports, Logs, & Documents

Reminder: Please make sure the HAVEN ID number is completed at the top of each quarterly report form, or the form may not be accepted.

Quarterly Therapist Report

Quarterly Medication Management Report

​Quarterly Practice Liaison Report

​Monthly Meeting Log

HAVEN Authorization - Blank

Other Documents

Credit Card Authorization Form

Continuing Education Resources

​Donation Form

​Talbott Recovery Campus Medication Guide for a Safe Recovery

​RecoveryTrek Online Enrollment Packet

Speaker Request Form

 

Applicable Statutes

Connecticut General Statute Sec. 19a-12a

Connecticut General Statute Sec. 19a-12b

Connecticut General Statutes 19a-12e

HAVEN provides a safe environment to coordinate evaluation, treatment, education, rehabilitation, monitoring, and supportive services for healthcare professionals.

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