Activity Name First Last Date MM slash DD slash YYYY Time Hours : Minutes AM PM AM/PM Activity: What, Where, and with Who? Type of Activity Meeting / Sponsor Peer Support / Recovery Coaching Family / Social Does this activity need approval? Yes I am asking for permission No I am logging a recovery activity I'm not sure (staff will reach out) Consent I understand that in order to have my activity approved it must be submitted 12 hours in advance of the activity and that approval may be subject to revocation by Executive Staff for any reason at any time. I agree that I will only engage in recovery related activities for the first 20 days (probationary period) Δ
