Peer Health Assistance Programs
Reports Contact
Participant Site Peer Assistance Services
Dentists Mental health Professionals Nurses Pharmacists Veterinary Professionals Other healthcare professionals
Programs Dentists Mental health Professionals Nurses Pharmacists Veterinary Professionals Other healthcare professionals ReportsContact
Peer Health Assistance Programs
Participant SitePeer Assistance Services
Back to Participant site

Participant Reports

 

All reports are due on the 4th of the month.
Quarterly reports are due in January, April, July, and October.

Reports may be submitted by email to reports@peerassistanceservices.org or faxed to 720.213.1007

 

Consent for Release of Information

Annual History and Physical Form

PDMP Record Request

Provider Report (Medical and Psychiatric)

Provider Verification Form

Recovery Maintenance Plan

Sponsor Report

Support Group Meeting Verification Form

Talbott Medication Guide for Safe Recovery 

Therapist Report (Group or Individual)

 
Program FAQ
FAQ about program
Contact Us

2170 South Parker Road, Suite 229 | Denver, Colorado 80231 | 303.369.0039
734 Main Street, Suite 120 | Grand Junction, Colorado 81501 | 970.986.4360

Info@PeerAssistanceServices.org

©2025 Peer Assistance Services, Inc.