The following are PDF files. If you don't have Adobe Acrobat Reader to access PDF files, you may download it here.     

APPLICATIONS

Certificate of Good Standing as a Treatment Provider for Impaired Physicians
Renewal of Good Standing as a Treatment Provider for Impaired Physicians
  

MISCELLANEOUS 

Declaration of Compliance 
Alcohol & Drug Rehabilitation Attendance Log
Instructions on How to Submit Specimens
Supervising Physician's Reporting Form   
Monitoring Physician Reporting Form  
Instructions for Completing Log of Controlled  Substances Prescribed, Administered, Dispensed

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