Once you have completed the Life Stone Annual Training, please CHECK THE BOX below that you agree and sign electronically. Thank you!

PLEASE MAKE SURE YOU CHECK BOX!

ACKNOWLEDGMENT & AGREEMENT:

I acknowledge that I viewed and read Life Stone’s Annual Staff Training. I have received instruction on the following: Life Stone Policies and Procedures, Emergency Response Plans (Active Suicidality, Active Shooter, Emergency Evacuation, Escalated Client, Medical Emergency, Fire, Infectious Disease), Incident & Sentinel Reporting Protocol, CPR and First Aid Access, Client Eligibility, Client Intake & Discharge Protocols, Non-Discrimination Policy, Medication Management Storage and Administration, Client Rights, Provider Code of Conduct, Background Checks, Reporting Requirements (including prevention, signs and symptoms), Staff & Client Grievance Procedures, Crisis Intervention (clients with suicidality, intoxicated clients) Behavior Management (restraint, de-escalation technique, appropriate & inappropriate behavior of clients and staff), Firearms and Smoking Policies Applicable Utah DHS General and Categorical licensing rules (outpatient treatment). I have watched the video and read the corresponding training and I understand and agree to adhere to these policies and procedures.

Electronic Signature:

Date: