This regulation requires substance use disorder treatment projects to maintain complete client records for each individual, including consent forms, correspondence, medication records, referral contracts, and activity notes. Records must be kept on standardized project client record forms. As part of Chapter 709, which governs licensing of drug and alcohol treatment facilities (including detoxification and treatment/rehabilitation services), this client records requirement applies to those licensed SUD facilities.
View official source28 Pa. Code § 709.72 - Client records State Regulations Compare (a) There shall be a complete client record on an individual which includes information relative to the client's involvement with the project. This shall include, but not be limited to, the following: (1) Consent forms. (2) Client-related correspondence. (3) Medication records. (4) Referral contract. (5) Activity notes. (b) The project shall develop and maintain client records on standardized project client record forms. Notes 28 Pa. Code § 709.72 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare. No prior version found. State Regulations Toolbox