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* [https://hcpaw.portlandoregon.gov/u/pJ-Uck0flGm2n5Rx/ebafe306-2165-4f17-9d77-d6ef681969e3?l Color, blank] | * [https://hcpaw.portlandoregon.gov/u/pJ-Uck0flGm2n5Rx/ebafe306-2165-4f17-9d77-d6ef681969e3?l Color, blank] | ||
|This form should invariably be printed double-sided. | |This form should invariably be printed double-sided. This form was designed by Marcel Rodriguez (Arnold Creek NET) for Portland NET. | ||
|[[File:Form 5b.Individual Treatment Record.jpg|border|center|frameless|155x155px]] | |[[File:Form 5b.Individual Treatment Record.jpg|border|center|frameless|155x155px]] | ||
|} | |} |