Sarp shapes form 2026

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The document outlines the Substance Abuse Rehabilitation Program (SARP) Health and Physical Evaluation Screening (SHAPES) patient instructions and medical provider guidelines. It includes a series of questions for patients regarding their substance use, medical history, and current health status, which must be completed before treatment. Medical providers are instructed to assess the patient's physical and mental stability, recommend further treatment options, and conduct necessary lab tests prior to SARP admission.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your identifying information at the bottom of all four pages. This is crucial for proper documentation.
Proceed to complete questions 1 through 26 on pages 1 and 2. These questions cover your substance use history, symptoms experienced, and any prior treatments.
For each question, select 'YES' or 'NO' as applicable. If you answer 'YES', provide additional details where prompted.
Ensure you list any medications you are currently taking and any allergies you may have in the designated sections.
Review all entries for accuracy before submitting the form. This ensures that your Primary Care Manager has the correct information for your evaluation.

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