The Right Services Right Time committee of the Pierce County Opioid Task Force is collecting community-based intake forms used in Pierce County to assess the needs of a person with substance use disorder. For example, forms that the various first responder agencies use when someone wants help as well as service providers such as the Recovery Cafes. The committee is less interested in clinic-based intake forms and more interested in looking at intake forms used in the field.

These forms will be reviewed by committee members to identify key data collection fields and algorithms for care, so that new service providers will not need to reinvent a new intake form but can build from existing forms being used. It was suggested that the Coalition to End Homelessness may have some examples of intake forms.  If you have an intake form to share with the committee, please reply to this email with a copy attached.

Darla J. Ridilla

Administrative Assistant II

Centers for Excellence

(253) 798-4719 o • dridilla@tpchd.org

(253) 651-2086 c • www.phcfe.org