Read Final Policy & Procedured 11-13-03.PDF text version

12- STEP MEETINGS VERIFICATION FORM

This form must be completed and returned to your treatment counselor at the beginning of every week. Please have your sponsor or the person in charge of each meeting sign to verify your attendance. Please note that your attendance can and will be verified.

Name: _______________________________________

DOB: __________________

DATE: _____________ LOCATION: ____________________________________________________ TOPIC: ____________________________________________________________________________ SIGNATURE OF SPONSOR/GROUP LEADER: __________________________________________

DATE: _____________ LOCATION: ____________________________________________________ TOPIC: ____________________________________________________________________________ SIGNATURE OF SPONSOR/GROUP LEADER: __________________________________________

DATE: ______________ LOCATION: __________________________________________________ TOPIC: ____________________________________________________________________________ SIGNATURE OF SPONSOR/GROUP LEADER: __________________________________________

DATE: _______________ LOCATION: __________________________________________________ TOPIC: ____________________________________________________________________________ SIGNATURE OF SPONSOR/GROUP LEADER: __________________________________________

DATE: _______________ LOCATION: __________________________________________________ TOPIC: ____________________________________________________________________________ SIGNATURE OF SPONSOR/GROUP LEADER: __________________________________________

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Final Policy & Procedured 11-13-03.PDF