{"id":693,"date":"2026-07-06T18:39:51","date_gmt":"2026-07-06T18:39:51","guid":{"rendered":"https:\/\/dev-hope-council-2026.pantheonsite.io\/?page_id=693"},"modified":"2026-09-08T15:07:35","modified_gmt":"2026-09-08T20:07:35","slug":"tx-provider-update","status":"publish","type":"page","link":"https:\/\/www.hopecouncil.org\/es\/contact\/tx-provider-update\/","title":{"rendered":"Actualizaci\u00f3n para proveedores de servicios de Texas"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-color:var(--awb-color5);--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:40px;--awb-padding-bottom:20px;--awb-background-image:radial-gradient(circle at center center, var(--awb-custom_color_4) 0%,rgba(203,211,209,0.6) 100%);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-six\" style=\"--awb-text-color:var(--awb-color5);--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h6 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">For Treatment Providers<\/h6><\/div><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-text-color:var(--awb-color1);--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"font-family:&quot;Poppins&quot;;font-style:normal;font-weight:700;margin:0;\">Treatment Provider Update<\/h2><\/div><div class=\"fusion-text fusion-text-1 fusion-text-no-margin\" style=\"--awb-text-color:var(--awb-custom_color_3);--awb-margin-top:20px;--awb-margin-bottom:30px;\"><p>Submit a monthly update on a client Hope Council referred to your agency.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-flex-align-self-stretch fusion-no-small-visibility\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><aside class=\"hc-notice\" role=\"note\" aria-labelledby=\"hcNoticeTitle\">\n  <span class=\"hc-notice__icon\" aria-hidden=\"true\">\n    <svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\">\n      <path d=\"M12 7v7\"\/><path d=\"M12 17.4v.2\"\/>\n    <\/svg>\n  <\/span>\n  <div class=\"hc-notice__body\">\n    <p class=\"hc-notice__title\" id=\"hcNoticeTitle\">For referred treatment providers only<\/p>\n    <p class=\"hc-notice__text\">This form is for licensed treatment providers submitting a required monthly update on a client Hope Council referred to your agency. It is not a public form.<\/p>\n  <\/div>\n<\/aside><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch fusion-no-medium-visibility fusion-no-large-visibility\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><aside class=\"hc-notice\" role=\"note\" aria-labelledby=\"hcNoticeTitle\">\n  <span class=\"hc-notice__icon\" aria-hidden=\"true\">\n    <svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\">\n      <path d=\"M12 7v7\"\/><path d=\"M12 17.4v.2\"\/>\n    <\/svg>\n  <\/span>\n  <div class=\"hc-notice__body\">\n    <p class=\"hc-notice__title\" id=\"hcNoticeTitle\">For referred treatment providers only<\/p>\n    <p class=\"hc-notice__text\">This form is for licensed treatment providers submitting a required monthly update on a client Hope Council referred to your agency. It is not a public form.<\/p>\n  <\/div>\n<\/aside><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-column-gap:15px;--awb-row-gap:15px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-row fusion-flex-align-items-center\"><div ><a class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_self\" href=\"#form\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Start Update<\/span><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column\" 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gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_38'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='ginput_container'><input name='input_38' id='input_12_38' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_12_38'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_12_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Your information\nThe provider completing this report.\n<hr><\/div><div id=\"field_12_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_3'><span class='gform-field-label__text'>Reporting agency name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_12_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_4'><span class='gform-field-label__text'>Your first name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_12_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_5'><span class='gform-field-label__text'>Your last name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_12_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_6'><span class='gform-field-label__text'>Credentials \/ license (e.g. SAC, CSAC, LPC)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_12_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_7'><span class='gform-field-label__text'>Work email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_12_7' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_12_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_8'><span class='gform-field-label__text'>Work phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_12_8' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_9\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Client information\n<hr><\/div><div id=\"field_12_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_10'><span class='gform-field-label__text'>Client first name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_12_10' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_11'><span class='gform-field-label__text'>Client last name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_12_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_12\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_12'><span class='gform-field-label__text'>Client date of birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_12_12'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_12'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_12' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_12' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_12' aria-label='Client date of birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_13\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_13'><span class='gform-field-label__text'>Last 4 digits of client SSN<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_13' id='input_12_13' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_12_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Reporting period\n<hr><\/div><div id=\"field_12_15\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_15'><span class='gform-field-label__text'>Date of this report<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_12_15'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_15'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_15' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_15' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_15' aria-label='Date of this report: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_16\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_16'><span class='gform-field-label__text'>Date client admitted to program<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_12_16'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_16'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_16' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_16' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_16' aria-label='Date client admitted to program: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_17'><span class='gform-field-label__text'>As of (date client last seen)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_12_17'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_17'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_17' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_17' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_17' aria-label='As of (date client last seen): Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_18\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_18'><span class='gform-field-label__text'>Next scheduled treatment appointment<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_12_18'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_18'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_12_18' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_12_18' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_12_18' aria-label='Next scheduled treatment appointment: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_12_19\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Program involvement\n<hr><\/div><div id=\"field_12_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_21'><span class='gform-field-label__text'>Total number of sessions<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_12_21' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_22'><span class='gform-field-label__text'>Individual counseling sessions<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_12_22' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_23'><span class='gform-field-label__text'>Group therapy sessions<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_12_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_12_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_5col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Services involved (check all that apply)<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_12_24'><div class='gchoice gchoice_12_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Continuing care'  id='choice_12_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_1' id='label_12_24_1' class='gform-field-label gform-field-label--type-inline'>Continuing care<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='IOP'  id='choice_12_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_2' id='label_12_24_2' class='gform-field-label gform-field-label--type-inline'>IOP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='MAT'  id='choice_12_24_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_3' id='label_12_24_3' class='gform-field-label gform-field-label--type-inline'>MAT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='12-step meeting attendance'  id='choice_12_24_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_4' id='label_12_24_4' class='gform-field-label gform-field-label--type-inline'>12-step meeting attendance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='Tobacco cessation'  id='choice_12_24_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_5' id='label_12_24_5' class='gform-field-label gform-field-label--type-inline'>Tobacco cessation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.6' type='checkbox'  value='Outpatient Individual\/Group'  id='choice_12_24_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_6' id='label_12_24_6' class='gform-field-label gform-field-label--type-inline'>Outpatient Individual\/Group<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_12_24_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.7' type='checkbox'  value='Other'  id='choice_12_24_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_24_7' id='label_12_24_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_25\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_25'><span class='gform-field-label__text'>Other \u2014 describe<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_12_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Client status\n<hr><\/div><fieldset id=\"field_12_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>The client is<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_27'>\n\t\t\t<div class='gchoice gchoice_12_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Following recommended course of treatment'  id='choice_12_27_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_0' id='label_12_27_0' class='gform-field-label gform-field-label--type-inline'>Following recommended course of treatment<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='In partial compliance'  id='choice_12_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_1' id='label_12_27_1' class='gform-field-label gform-field-label--type-inline'>In partial compliance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_27_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Re-admitted to program'  id='choice_12_27_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_2' id='label_12_27_2' class='gform-field-label gform-field-label--type-inline'>Re-admitted to program<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_27_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Discharged in compliance'  id='choice_12_27_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_3' id='label_12_27_3' class='gform-field-label gform-field-label--type-inline'>Discharged in compliance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_27_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Discharged in non-compliance'  id='choice_12_27_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_4' id='label_12_27_4' class='gform-field-label gform-field-label--type-inline'>Discharged in non-compliance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_27_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='Discharged in compliance except money owed (do not complete client until further notice)'  id='choice_12_27_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_27_5' id='label_12_27_5' class='gform-field-label gform-field-label--type-inline'>Discharged in compliance except money owed (do not complete client until further notice)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_28\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_28'><span class='gform-field-label__text'>Prognosis<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_12_28' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_29\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Degree of use\nIf partial or continued use is indicated, please add detail in the notes below.\n<hr><\/div><fieldset id=\"field_12_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-columns\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Client self-reports<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_30'>\n\t\t\t<div class='gchoice gchoice_12_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Full abstinence'  id='choice_12_30_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_30_0' id='label_12_30_0' class='gform-field-label gform-field-label--type-inline'>Full abstinence<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Partial abstinence'  id='choice_12_30_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_30_1' id='label_12_30_1' class='gform-field-label gform-field-label--type-inline'>Partial abstinence<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Continued use'  id='choice_12_30_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_30_2' id='label_12_30_2' class='gform-field-label gform-field-label--type-inline'>Continued use<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_33\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_12_33'><span class='gform-field-label__text'>Attach report<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_12_33' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_12_33&quot;,&quot;container&quot;:&quot;gform_multifile_upload_12_33&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_12_33&quot;,&quot;filelist&quot;:&quot;gform_preview_12_33&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.hopecouncil.org\\\/?gf_page=35dd6b39a05bf44&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.hopecouncil.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.hopecouncil.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:12,&quot;field_id&quot;:33,&quot;_gform_file_upload_nonce_12_33&quot;:&quot;d836bcf105&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;2&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_12_33&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_12_33' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_12_33' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_12_33\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_33'>Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB, Max. files: 2.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_12_33'><\/ul> <div id='gform_preview_12_33' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_12_34\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Notes\n<hr><\/div><div id=\"field_12_36\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_36'><span class='gform-field-label__text'>Client goals and progress<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_12_36' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_12_37\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_turnstile'><div class=\"cf-turnstile\" id=\"cf-turnstile_12\" data-js-turnstile data-response-field-name=\"cf-turnstile-response_12\" data-theme=\"auto\" data-size=\"normal\" data-sitekey=\"0x4AAAAAAECOGzwMyx9iFJAJ\"><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button class=\"gform_button button fusion-button\" id=\"gform_submit_button_12\" type=\"submit\" onclick=\"gform.submission.handleButtonClick(this);\"><span class=\"fusion-button-text\">Submit Monthly Update<\/span><i class=\"glyphicon fa-long-arrow-alt-right fas\" aria-hidden=\"true\"><\/i><\/button> <input type='hidden' class='gform_hidden' name='gform_submission_speeds' value='{&quot;pages&quot;:[]}' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_12' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_12' id='gform_theme_12' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_12' id='gform_style_settings_12' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_12' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='12' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='KgUagMPeP8wipnChj2jsl26IAWSL1ppj0TGOxqs0cyrL6e9lW43SOUuDNcZDLVXG8ogxzf7j1lK\/jOWIxFRSxSxQZmRQRyoiALLE1x2YcQxXOVI=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_12' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_12' id='gform_target_page_number_12' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_12' id='gform_source_page_number_12' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_12' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:40px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_4_5 4_5 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:80%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.4%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.4%;--awb-width-medium:80%;--awb-order-medium:0;--awb-spacing-right-medium:2.4%;--awb-spacing-left-medium:2.4%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-three\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h3 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Common Questions<\/h3><\/div><style type=\"text\/css\">.fusion-faqs-wrapper #accordian-1 .fusion-panel { border-color:var(--awb-color8); }.fusion-faqs-wrapper #accordian-1 .fusion-panel:hover{ border-color: var(--awb-custom_color_1); }.fusion-accordian #accordian-1 .panel-title a .fa-fusion-box:before{ font-size: 16px;width: 16px;}.fusion-accordian #accordian-1 .panel-title a .fa-fusion-box{ color: var(--awb-color5);}.fusion-accordian #accordian-1.fusion-toggle-icon-right .fusion-toggle-heading{ margin-right: 34px;}.fusion-accordian  #accordian-1 .panel-title a{font-family:\"Poppins\";font-style:normal;font-weight:600;}.fusion-accordian  #accordian-1 .panel-title a:not(:hover){}.fusion-accordian  #accordian-1 .toggle-content{color:var(--awb-color8);font-family:var(--awb-typography4-font-family);font-weight:var(--awb-typography4-font-weight);font-style:var(--awb-typography4-font-style);}.fusion-accordian #accordian-1 .panel-title a:hover,.fusion-accordian #accordian-1 .panel-title a.hover { color: var(--awb-color8);}.fusion-faq-shortcode .fusion-accordian #accordian-1 .fusion-toggle-boxed-mode:hover .panel-title a { color: var(--awb-color8);}.fusion-accordian #accordian-1.fusion-toggle-icon-unboxed .panel-title a:hover .fa-fusion-box,.fusion-accordian #accordian-1.fusion-toggle-icon-unboxed .panel-title a.hover .fa-fusion-box { color: var(--awb-color8); }.fusion-faqs-wrapper .fusion-accordian #accordian-1 .panel-title a.active{ color: var(--awb-color8) !important;}.fusion-faqs-wrapper .fusion-accordian  #accordian-1.fusion-toggle-icon-unboxed .fusion-panel .panel-title a.active .fa-fusion-box{ color: var(--awb-color8) !important;}<\/style><div class=\"fusion-faq-shortcode\" style=\"\"><div class=\"fusion-faqs-wrapper\"><div class=\"accordian fusion-accordian\"><div class=\"panel-group  fusion-toggle-icon-right fusion-toggle-icon-unboxed\" id=\"accordian-1\"><div class=\"fusion-panel panel-default fusion-faq-post fusion-faq-post-2231 treatment-provider-update \"><span class=\"entry-title rich-snippet-hidden\">Who is allowed to submit this form?<\/span><span class=\"vcard rich-snippet-hidden\"><span class=\"fn\"><a href=\"https:\/\/www.hopecouncil.org\/es\/author\/dooley\/\" rel=\"author\">dooley<\/a><\/span><\/span><span class=\"updated rich-snippet-hidden\">2026-07-14T19:12:40-05:00<\/span><div class=\"panel-heading\"><h4 id=\"faq_1-2231\" class=\"panel-title toggle\"><a data-toggle=\"collapse\" class=\"collapsed\" data-parent=\"#accordian-1\" data-target=\"#collapse-1-2231\" href=\"#collapse-1-2231\" aria-expanded=\"false\"><div class=\"fusion-toggle-icon-wrapper\"><div class=\"fusion-toggle-icon-wrapper-main\"><div class=\"fusion-toggle-icon-wrapper-sub\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/div><\/div><\/div><div class=\"fusion-toggle-heading\">Who is allowed to submit this form?<\/div><\/a><\/h4><\/div><div id=\"collapse-1-2231\" aria-labelledby=\"faq_1-2231\" class=\"panel-collapse collapse\"><div class=\"panel-body toggle-content post-content\"><p>Only the licensed treatment provider a client was referred to. The verification step matches your work email and the client&#8217;s last-4 SSN and date of birth against the referral on file \u2014 so client treatment updates can&#8217;t be submitted by anyone else.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default fusion-faq-post fusion-faq-post-2233 treatment-provider-update \"><span class=\"entry-title rich-snippet-hidden\">How often do I submit an update?<\/span><span class=\"vcard rich-snippet-hidden\"><span class=\"fn\"><a href=\"https:\/\/www.hopecouncil.org\/es\/author\/dooley\/\" rel=\"author\">dooley<\/a><\/span><\/span><span class=\"updated rich-snippet-hidden\">2026-07-14T19:12:59-05:00<\/span><div class=\"panel-heading\"><h4 id=\"faq_1-2233\" class=\"panel-title toggle\"><a data-toggle=\"collapse\" class=\"collapsed\" data-parent=\"#accordian-1\" data-target=\"#collapse-1-2233\" href=\"#collapse-1-2233\" aria-expanded=\"false\"><div class=\"fusion-toggle-icon-wrapper\"><div class=\"fusion-toggle-icon-wrapper-main\"><div class=\"fusion-toggle-icon-wrapper-sub\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/div><\/div><\/div><div class=\"fusion-toggle-heading\">How often do I submit an update?<\/div><\/a><\/h4><\/div><div id=\"collapse-1-2233\" aria-labelledby=\"faq_1-2233\" class=\"panel-collapse collapse\"><div class=\"panel-body toggle-content post-content\"><p>Monthly. Monthly reports are mandatory for clients referred through the Intoxicated Driver Program. If there&#8217;s a significant change in status between reports, notify Hope Council immediately.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default fusion-faq-post fusion-faq-post-2235 treatment-provider-update \"><span class=\"entry-title rich-snippet-hidden\">What if the client&#8217;s information doesn&#8217;t verify?<\/span><span class=\"vcard rich-snippet-hidden\"><span class=\"fn\"><a href=\"https:\/\/www.hopecouncil.org\/es\/author\/dooley\/\" rel=\"author\">dooley<\/a><\/span><\/span><span class=\"updated rich-snippet-hidden\">2026-07-14T19:13:17-05:00<\/span><div class=\"panel-heading\"><h4 id=\"faq_1-2235\" class=\"panel-title toggle\"><a data-toggle=\"collapse\" class=\"collapsed\" data-parent=\"#accordian-1\" data-target=\"#collapse-1-2235\" href=\"#collapse-1-2235\" aria-expanded=\"false\"><div class=\"fusion-toggle-icon-wrapper\"><div class=\"fusion-toggle-icon-wrapper-main\"><div class=\"fusion-toggle-icon-wrapper-sub\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/div><\/div><\/div><div class=\"fusion-toggle-heading\">What if the client&#8217;s information doesn&#8217;t verify?<\/div><\/a><\/h4><\/div><div id=\"collapse-1-2235\" aria-labelledby=\"faq_1-2235\" class=\"panel-collapse collapse\"><div class=\"panel-body toggle-content post-content\"><p>The update stays locked and Hope Council staff are notified of the attempt. If you believe you have an active referral that isn&#8217;t matching, call 262-658-8166 to confirm the client&#8217;s details on file.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default fusion-faq-post fusion-faq-post-2237 treatment-provider-update \"><span class=\"entry-title rich-snippet-hidden\">Where does the completed report go?<\/span><span class=\"vcard rich-snippet-hidden\"><span class=\"fn\"><a href=\"https:\/\/www.hopecouncil.org\/es\/author\/dooley\/\" rel=\"author\">dooley<\/a><\/span><\/span><span class=\"updated rich-snippet-hidden\">2026-07-14T19:13:31-05:00<\/span><div class=\"panel-heading\"><h4 id=\"faq_1-2237\" class=\"panel-title toggle\"><a data-toggle=\"collapse\" class=\"collapsed\" data-parent=\"#accordian-1\" data-target=\"#collapse-1-2237\" href=\"#collapse-1-2237\" aria-expanded=\"false\"><div class=\"fusion-toggle-icon-wrapper\"><div class=\"fusion-toggle-icon-wrapper-main\"><div class=\"fusion-toggle-icon-wrapper-sub\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/div><\/div><\/div><div class=\"fusion-toggle-heading\">Where does the completed report go?<\/div><\/a><\/h4><\/div><div id=\"collapse-1-2237\" aria-labelledby=\"faq_1-2237\" class=\"panel-collapse collapse\"><div class=\"panel-body toggle-content post-content\"><p>Directly to Hope Council&#8217;s IDP coordinator (coordinator@hopecouncil.org). It is handled under the same federal and state confidentiality protections as all Hope Council client records.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":590,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-693","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/pages\/693","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/comments?post=693"}],"version-history":[{"count":24,"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/pages\/693\/revisions"}],"predecessor-version":[{"id":4291,"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/pages\/693\/revisions\/4291"}],"up":[{"embeddable":true,"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/pages\/590"}],"wp:attachment":[{"href":"https:\/\/www.hopecouncil.org\/es\/wp-json\/wp\/v2\/media?parent=693"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}