| Form |
When to be used |
| Criminal Case Management Referral Form |
To refer case to Leon County VTC Coordinator for review of eligibility |
| Department of Veterans Affairs Request for and Authorization to Release Medical Records or Health Information |
Included with referral form to allow the Veterans Justice Officer (VJO) to access VA records to assist with review of eligibility |
| Department of Veterans Affairs Form 10-10EZ and Supplement Form |
Included with referral form when a Veteran is registered in another VA region besides the North Florida/South Georgia region; allows the VJO to access records from Veterans original VA region to assist with review of eligibility |
| Leon County VTC Consent for Disclosure of Confidential Information |
Included with referral form; allows for release of approved treatment information between individuals /programs/facilities while Veteran is enrolled in Leon County VTC |
| Leon County VTC Participation and Graduation Contract |
Signed by the Veteran and his/her Defense Attorney upon entry into the Leon County VTC indicating the Veteran understands the rules and requirements of the program and for graduation |
| Acknowledgement of Receipt of Leon County VTC Participant Handbook |
Signed by the Veteran and his/her Defense Attorney upon entry into the Leon County VTC indicating they have been given a Leon County VTC participant handbook and will review its content |
| Intake Essay Requirements |
Identifies content for intake essay that must be completed in Phase 1 |
| Graduation Essay Requirements |
Identifies content for graduation essay that must be completed two weeks prior to graduation ceremony |