PEIR Problem Solving-Resolution Form 

 

The attached form was developed as a tool for you to address problems you may encounter in your role as a PEIR facilitator. This form was designed to address issues with health care providers, other PEIRs, your manager or Local as it relates to your role as a PEIR facilitator. 

The Committee on Substance Abuse is always looking at ways to support your efforts as a PEIR facilitator and offers this as a means to resolve issues.

When filling out this form please be as specific and concise as possible with names, dates, and any other pertinent information.

 

To Print the form, click here.   

(For your information:  You may Download this form, if you have Word 97 or higher, type it in and mail it, or print it out and send it.)     

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