Rehabilitation Contract Reports

Rehabilitation Contract reports are due on the 4th of the month
(Reports for the January reporting period are due February 4th.) 

Fax reports to:  720.213.1007 (Last Name A – L)   or    720.213.0002  (Last Name M – Z)

Email reports to: 

Notice to clients: Standard email is an unsecured method of correspondence; therefore reports submitted via this method may be at risk for interception. PAS uses ZixCorp encryption for all email communication with clients.

Participants may choose one of the four Self-Status Reports to submit each reporting period, it is not necessary to submit all four versions.

 Addictionologist Report 

Annual History & Physical 

Meeting Verification

Group Meeting Verification 

Opiate Replacement Therapy Report 

Pain Management Provider Report 

PDMP Record Request – Email Receipt 

Dental Practice Monitor Report 

Mental Health Professional Practice Monitor Report  

Nursing Practice Monitor Report  

Veterinarian Practice Monitor Report 

Psychiatrist Report 

Self Status 

Self Status Education Employment Report 

Self Status Monthly Recovery Plan 

Self Status Wellness Plan 

Sponsor Report 

LPN Supervisor Report

RN Supervisor Report (Non-Clinical) 

RN Supervisor Report 

Pharmacist Supervisor Report 

Supervisor Report – Veterinarian 

Mental Health Professional Supervisor Report

Chiropractor Supervisor Report 

Registered Dental Hygienist Supervisor Report 

Respiratory Therapist Supervisor Report 

Surgical Assistant Supervisor Report

Therapist Report

Therapist-Psychologist Report 

Treatment Provider Report