Free Motion for Summary Judgment - District Court of Delaware - Delaware

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V · CIVIGENiCS, INC. — T _ A A I
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DISCHARGE SUMMARY i __
F Program: ” _ ·_ j ?
` cnenrs Name: ; saw: r>?<>ӎՎ 252 V
A CIient's Address: i {5 .1. 4 QZ V Qjpgmdf A 5 (` I I
— Date of Birth: §°%[;;§ Z :2 2 I Eth '
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Education: V A i · A `
Counselor: § eéééfu/A g
Admission Date: - c9~ V
Admitted From: DGP ceun UnVg;4ggp_qr__gig@e&eygn_;iigeys¤igey4N_.¤.Keye/4:eoernpme ddddi eee. ee·e
QEYE IISA if ASAA if WEEE;»EqWEvMW—@;Ch~re; Hrzn Elcresm C|CrestC Elcresrs ClAoN CIAcc iZiAcs¤lGi¤c.n= 1
Deon Eloco D ci Dwcn Eipccc Diviocc ciswnc Cisvop Eiovop DOther
Discharge Eligibility Date: 3 és O é` .
Departure Date: 53 4' . i A
_ Type of Discharge: Cllc£pieraen Elvoluntary DBehavioraI EIMedical EIPsych C|Positive Urine V
Cllntervention EITransfers CIOther
Discharge Address: /519 / €'[é>% &, Mr . E/ig V / r
IDENTIFYING DATA:
HE" g ie
- 2. Ethnicity: Eiieéeesren DAfrican American CIHispanic CIAsian CIAmerican indien DOther
Host Address: `
_' .;...eA/ I., /» -, 1,: ..4444/ - -» 11 1 A'
Meme { Address i Pnene r
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;&g—n iZe Unknown CI A
Minimum Recommendation: Crest lj Aftercare EI Communitylj None EI
Referrals: V
Referrals made D Referral needs to be made D ‘*?¥< (see pg. 4 for details) rl _
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TiTT§ TT’iiCase-1 :04-cv-00177-SLR: "`"TU6?§UTYTl `8"`—I"TFIIGGCO2/O3/2006 V Page 2 01**4* , mm
~ or I c1v1GEN1cs, INC. y J
ASSESSMENT OF WHAT BROUGHT CLIENT INTO TREATMENT: I i
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1. Drug istory: `· Q/Y ~.O‘ fYl0r/w` 4 rr e lf .0. ‘ O·’Cé»/he.~·-lZ*/. 0, I
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TREATMENT OVERVIEW: — · I
All clients who successfully complete the Civigenics, Inc. Program participate in three phases of treatment;
Orientation Phase teaches client basic rules and expectations for compliance in the program; Primary Phase
t focuses on assisting client on changing cognitive thought process, anti-social values and developing emotional
maturity Transition (Re·entry) Phase assist the client in internalizing these changes, practicing and habituating how
to apply these changes in daily living.
A counselor and the client completed an extensive assessment -to identify individual treatment issues. In order to
address treatment issues, the client participated in daily community activities. These include treatment job positions
of varying responsibility, attending therapy groups; staff and peer facilitated seminars, encounter groups, addictions- _
related seminars. Client participates in individual counseling sessions and received a treatment plan addressing
problem areas as identified in the client assessment. Every treatment plan has long and short·term goals, and
various tasks to complete. _
Issues identified on the Master Treatment Plan and Subsequent Treatment Plan Updates
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T e lient's · rog ess on treatment plan issues I /
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_ ·— it CIVIGENICS, INC. _ _ - [
_ The client's behavior in the community was generally: [ [ ‘ ·· ·‘ [
li 20 1 .4,C 41,.. rl ·‘ ZA ! ‘ . A /. ~ · ..e! · —
t issues hat were o rey tplan; . --—---—--——+e‘
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`iii TEi& iliiiKiH6i5¥EéHHe§}§`i_i [
Client was discharged from the Civigenics, Inc. Program and transferred to: [
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a [
. S c ic nature of disch rge·— ` ·
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PROGNOSIS: ' [
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Re sp or Pr gn sls: ‘ /1 w /,./.. i gl"' - . /Wé/U
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AM—Wi‘i.i?>lien roup to assist in remaining free from substance
abuse. g — ___ M_ _._e.-_--l
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Revision l|/ 17/03 [gif ~
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ititt C V¥OOT77-SLR Document 40‘8_¤ _ iiiii Page40f4 ` _‘
D it CIVIGENICS, INC. it C
REFERRALS: _ _ C V-
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Name Address/Phone gg? Contact Person
Namehgg Address/Phone Contact Person , P [
C C lAddréssIPhone Contact Person `
Name Address/Pho · Contact Person
__so _ts__tr __ t_ss_a At;mrt._e@ .ers ¤¤n2_H?t»»»»»A2¤m¤¤1Psr$¤¤~e—~—»~~—ee—·»—e~ e——— ~~—~
Name Ad ess/Phone Contact Person I
Client Sign re ` Date Supervisor Signature N Dat P P
i may /2 2 .04 V3 001/
Counselor S gnature at Director ture Date »
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Case 1:04-cv-00177-SLR

Document 40-8

Filed 02/03/2006

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Case 1:04-cv-00177-SLR

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Filed 02/03/2006

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Case 1:04-cv-00177-SLR

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Case 1:04-cv-00177-SLR

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