Crystal Creek Lodge Treatment Center in Browning, Montana.

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CRYSTAL CREEK



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Crystal Creek Lodge is accredited by the Commission on Accreditation of Rehabilitation Facilities



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Crystal Creek Lodge holds licenses granted by the Montana Department of Public Health & Human Services



Indian Health Service
Crystal Creek Lodge is funded by Indian Health Service.

INTAKE PACKETS (PDF)


Release of Information Authorization

Patient Registration and Release of Information

Adolescent Component

Parent Observation Checklist

Tribal Court Release of Information

Consent to Provide Treatment for Minor Client

Contract for Adolescent Treatment

Acknowledgement of Receipt of Notice of Privacy Practices-Adolescent

Federal Confidentiality Regulations

Brief Cognitive Assessment

Adolescent Program Evaluation

Accounting of Disclosure

Individual Case Staffing

Adolescent Admission Checklist

Alcohol and other Substance Staging Tool for Assessing and Placement

Screening Team Notification

Checklist Form

Intake Tracking Form

Transportation of Patients Policy

Admission Checklist

Federal Confidentiality Regulation

Drug Abuse Screening Test

Michigan Alcohol Screening Test

Patient Registration and Release of Information

Release of Information Authorization

Interpretive Summary

Chemical Dependency Management Information Systems

Progress Notes for Patients Placement

Physical Exam Form

Medical Issues in Order Prior to Clients Admission

Medications Not Allowed

Acknowledgement of Receipt of Notice of Privacy Practices

Patient Health Questionnaire

Medical Form

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2004-2015 Crystal Creek Lodge Treatment Center, Browning, Montana.