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Talking on phones

Participant Safe Contact List

Please read and sign the form below.

Participant Safe Contact List

Please indicate the type of contact permitted with Safe Contact #1
Should permitted types of contact be supervised with Safe Contact #1?
Please indicate the type of contact permitted with Safe Contact #2
Should permitted types of contact be supervised with Safe Contact #2?
Please indicate the type of contact permitted with Safe Contact #3
Should permitted types of contact be supervised with Safe Contact #3?
Please indicate the type of contact permitted with Safe Contact #4
Should permitted types of contact be supervised with Safe Contact #4?

Please note, only contacts approved in writing by guardian will be allowed to communicate with participant. Please notify case managers of any changes or updates to approved list.

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