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Get AL SASD ASAIS 4161 2007-2024
ASAIS ID: First Name: Last Name: Date of Birth: / / Co-Dependent/Collateral: Level of Care at Discharge: / Date of Last Contact: / Date of Discharge: MI: Yes No / / Reason for Discharge, Transfer or Discontinuance of Treatment Treatment Completed Left Against Professional Advice Terminated by Facility Transferred to Another Substance Abuse Treatment Program or Facility Transferred to Another Substance Abuse Treatment Program or Facility, but Did Not Report Incar.
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