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Chief Complaint/Problem statement
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Aftercare Plan Session Type
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Self-help and Supports
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The amount of support meetings you plan on attending per week?
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Name, location, and time of 3 meetings you could attend
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Do you have a sponsor
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Name and number of at least 2 to 3 sober supports to contact in case of relapse triggers or other problems.
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Spiritual, Recreational, and Social
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List recreational activities that pertain to your intellectual, physical, social, and spiritual wellbeing
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How many days per week do you plan on participating in these activies
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Mental and Physical Health
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Are you in need of further mental health treatment?
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If yes, please explain
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Do you have a primary doctor?
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Are you in need of further medical treatment?
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Financial
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Are you employed?
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If not employed, how do you plan on financial supporting yourself?
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Explain employment
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Recovery Environment
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Are you living in a safe environment that supports recovery?
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Aftercare Plan Summary
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Completed by:
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Date:
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