Substance Abuse Nonprofit Case File
Client Information
Full Name
Date of Birth
Gender
Phone
Email
Address
Referral Information
Referral Date
Referred By
Case Details
Presenting Issues
Substances Used
Use Frequency
Duration of Use
Prior Treatment History
Assessment / Evaluation
Risk Assessment
Goals
Barriers to Recovery
Support & Services
Services Provided
Referrals Made
Client Progress
Case Notes / Follow Up