Get One Year Sobriety Notebook

The One Year Sobriety Notebook is a crucial document for individuals seeking to demonstrate their commitment to sobriety and their readiness to return to nursing practice. This guide provides clear, step-by-step instructions to help users complete the form effectively and efficiently.

Follow the steps to fill out the One Year Sobriety Notebook online.

1. Use the ‘Get Form’ button to access the One Year Sobriety Notebook. This will enable you to download or open the document in your desired format.
2. Begin by completing the 'Information About You' section. Ensure that you accurately fill in your full name, submission date, and relevant dates related to your nursing license surrender or suspension. Be thorough; mark any non-applicable sections with 'N/A'.
3. Proceed to detail your résumé in Item 2. Attach a current résumé that includes your employment history, specifying roles held, duration of employment, reasons for leaving, and eligibility for rehire.
4. In Item 3, document your employment history since the surrender or suspension of your nursing license. List each employment chronologically and ensure to include a letter from your direct supervisor confirming your work performance.
5. Complete Item 4 by providing a comprehensive account of all treatments received for substance abuse. This should include admission and discharge summaries for each facility treated.
6. Detail your aftercare participation in Item 5, indicating your compliance with any treatment requirements, including documentation from your counselor regarding your progress.
7. Outline your Relapse Prevention Plan in Item 6. This should include insights into triggers and strategies for managing potential relapse risks in your recovery journey.
8. Schedule and submit the Addictionologist evaluation as directed in Item 7. Ensure you comply with all necessary steps including obtaining their credentials if required.
9. In Item 8, provide evidence of participation in a twelve-step program if applicable. Attach the required attendance sheets and answer the additional participation questions.
10. Document your drug screening participation per Item 9, outlining the requirements for successful screening and the actions taken to comply.
11. Complete Items 10 through 18 thoroughly, ensuring all requested information is provided, such as criminal record, health care provider details, and reference letters.
12. Review each section for completeness. Save the filled document to your device, and either download, print, or share as necessary.

Start filling out the One Year Sobriety Notebook online today to take the important step towards your nursing reinstatement.