Substance Abuse and Mental Health Publications SAMHSA Store - co missoula mt 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and department in the designated fields at the top of the form.
3. Fill in the date of your first class attended, ensuring accuracy for reimbursement eligibility.
4. Provide the instructor's name who taught your classes, as this will be required for certification.
5. After attending each class, have your instructor sign next to each corresponding class number to confirm attendance.
6. Finally, review all information for completeness and accuracy before signing and dating the form at the bottom.

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