2021 SB 123 Forms

Approved Cost Caps

2022 Approved Treatment Modalities and Cost Caps   Updated August 30, 2022

Pre-Sentence Invoice

Pre-Sentence Invoice-for-Purchase-of-Service-Form  - only needed for assessments PRIOR to Jan 1, 2023

Forms

SB 123 Assessment Summary Form  Updated January 1, 2023

SB123 Client_Placement_Agreement   Updated January 1, 2023

Monthly Progress Report Form  Updated January 1, 2023

Offender Forms

2021 SB123 Offender Reimbursement Remittance Form Updated August 20, 2021

SB123 Insurance Payment Remittance Form  Updated August 20, 2021

Pre-Sentence SASSI Forms

can be found on the Training page