Request a Treatment Plan Acknowledgement Signature

Use this form to request a treatment plan acknowledgement signature from a client. You will receive a confirmation email once the request has been sent.

You will not automatically receive a copy of the signed document. Please check the eSignature folder in Roots Recovery-Documents to see if the signed document has automatically downloaded.

Client Name*
First Last
Client eMail*
Client Date of Birth*
Primary Counselor*