Intervention Planning Form

Brings together what a professional needs to organise a family intervention around substance use. It records the requester's contact, the type of case, the hoped-for outcomes and the preferred date, time and venue. Aimed at therapists, treatment centres and specialist counsellors.

Use this template

In the Claude connectors directory

Full name

First Name

Last Name

Email

Phone number

Type of intervention

Outcomes you hope to achieve

Entry into a treatment programme Supervised detox Outpatient counselling Family therapy Sober living housing Ongoing follow-up

Preferred date

Preferred time

Proposed venue

Street Address

City

State / Province

ZIP / Postal Code

Additional comments

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