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Recovery Support Plan

Individualized recovery plan developed with your case manager.

Kura Solution

Appendix G — Recovery Support Plan

Individualized recovery plan developed with your case manager.

Header

Resident Name *

Case Manager

Date

Plan

Primary Recovery Goals

Housing Stability Plan

Employment / Education Plan

Legal / Supervision Compliance Plan

Healthcare / MAT Plan

Recovery Supports (Meetings, Coaching, Groups)

Barriers / Risk Factors

Strengths / Protective Factors

Target Review Date

Signatures

Resident Signature *

Sign here

Use mouse, trackpad, or finger to sign.

Resident Printed Name *

Date *

Case Manager Signature *

Sign here

Use mouse, trackpad, or finger to sign.

Case Manager Printed Name *

Date *

Electronic Signature ConsentI agree that the signature(s) I have provided above are my legal electronic signatures, with the same effect as a handwritten signature, under the federal E-SIGN Act (15 U.S.C. § 7001 et seq.) and applicable state law (UETA). I authorize Kura Solution to maintain this signed form as a legal record. I have had the opportunity to read and understand this form and my signature(s) are made knowingly and voluntarily.

A signed PDF copy will download to your device after submission. Records protected under 42 CFR Part 2 & HIPAA.