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) 

IPN Claim Process Instructions (August 2021) 

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) 

IPN Critical Incident Form 

IPN Exception Request 

IPN Provider Manual (April 2022) 

IPN Provider Manual (April 22) Release #1: Appendix O Revision  (May 2022) 

IPN RFP 

IPN RFP Amendment #1-4 

IPN Service Area Map 

IPN Sliding Fee Modification Notice (December 2020) 

IPN Transportation Receipt 

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 

IPN Transportation Receipt 

IBHRS State Waitlist Guide (January 2022)  

IDPH State Waitlist Cover Sheet 

State Waitlist Consent Template 

Recovery Peer Coaching Fact Sheet

Your Life Iowa Referral and Follow-up Process (March 2021) 

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