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Documents & Forms

Below are the documents and forms available for reference and use by IPN Contractors.

Claims

IPN Claim Progress Report (January 2019) 

IPN Claim Process Instructions (July 2020) 

Data Reporting

I-SMART Prevention User Manual (June 2019) 

I-SMART Prevention User Manual (August 2020)

I-SMART Support Documentation (Substance Use Disorders)

I-SMART Support Documentation (Problem Gambling)

Problem Gambling Treatment Data Entry Matrix (February 2021) 

SUD Treatment Data Entry Matrix (February 2021) 

General

IPN Contract Guidance for COVID-19 (July 2021) PDF

IPN Critical Incident Form PDF

IPN Exception Request PDF

IPN Provider Manual (July 2019) PDF

IPN Provider Manual Release #1 (August 2019) PDF

IPN Provider Manual Release #2 (February 2020) PDF

IPN Provider Manual Release #3 (July 2020) PDF

IPN Provider Manual Release #4 (November 2020) PDF

IPN Provider Manual Release #5 v2 (July 2021) PDF

RFA Appendix J (July 2021) PDF

IPN Provider Manual Release #6 (October 2021) PDF

IPN RFP PDF

IPN RFP Amendment #1-4 PDF

IPN Service Area Map PDF

IPN Sliding Fee Modification Notice (December 2020) PDF

IPN Transportation Receipt PDF

Your Life Iowa Logos 

Prevention

IDPH Prevention Guide (August 2019)

IPN Prevention Services Orientation Guide (January 2019) 

IPN Prevention Services Orientation Guide (July 2019)

IPN Prevention Services Orientation Guide (July 2020)

Responsible Gaming Presentation (September 2019) 

Treatment

IPN Exception Request PDF

IPN Transportation Receipt PDF

I-SMART State Waitlist Guide (September 2020) PDF

IDPH Statewide Waitlist Cover Sheet 

I-SMART Statewide Waitlist Consent PDF

Recovery Peer Coaching Fact Sheet PDF

 

Please direct questions and technical assistance requests to the IPN Help Desk at ipn@idph.iowa.gov.