Treatment Data System Forms

A-1 Admission and D-1 Discharge Form:

Admission/Discharge Manual (Word) | Admission/Discharge Manual (PDF)

Admission Form

A-1 Admission Form (PDF)

Discharge Form

D-1 Discharge Form (PDF)

Detox/Shelter Form

A-D Detoxification/Shelter Form (PDF)

Opioid Replacement Therapy (ORT) Update Form

Opioid Replacement Therapy Update Form (PDF)

Data Request Forms

  1. Proposal Form
  2. Request Form

If you have any questions about these forms, please contact the TDS Helpdesk at 287-4699 or by email at TDS.Helpdesk@maine.gov. Please print and copy as needed.

These forms are viewable or printable using Acrobat Reader. The free Adobe Acrobat Reader is necessary to view them. Printouts of these documents are also available upon request.