Contingency Fees Act, 1997
R 385.00
Prevention of and Treatment for Substance Abuse Act, 2008 (Act No. 70 of 2008)RegulationsRegulations for Prevention of and Treatment for Substance Abuse, 2013AnnexuresAnnexure F : FormsForm 7A : Application for admission as service user to treatment centre |
FORM 7A
APPLICATION FOR ADMISSION AS SERVICE USER TO TREATMENT CENTRE
Section 32(1)(a) of Prevention of and Treatment for Substance Abuse Act, 2008 (Act No. 70 of 2008)
(Regulation 47)
Name of treatment centre where admission is desired:
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First Name of service user
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Surname ..............................................................................................................................
Address of service user
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Reason for application: ............................................................................................................
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| 1. | My reference number is ................................................................(only in the case of returning service users) |
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Date of admission:
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Duration of stay in the treatment centre
Signature of the applicant: .......................................................................................................
