Restoration Family Services Forms

“Helping families provide missing pieces”

Welcome to the Restoration Family Services, Inc.’s “Service Forms” platform.

Please fill in all required fields *:

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RFS SACOT SIGN-IN FORM

Location: RFS DurhamRFS SmithfieldRFS Benson

Facilitator:

Full Name*

Date*

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ATTENDANCE LIST

My signature acknowledges that I have attended the SACOT group today.

Participant 1

Full Name

Signature*

Participant 2

Full Name

Signature*

Participant 3

Full Name

Signature*

Participant 4

Full Name

Signature*

Participant 5

Full Name

Signature*

Participant 6

Full Name

Signature*

Participant 7

Full Name

Signature*

Participant 8

Full Name

Signature*

Participant 9

Full Name

Signature*

Participant 10

Full Name

Signature*

Participant 11

Full Name

Signature*

Participant 12

Full Name

Signature*

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Stand: 01/08/2025

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RESTORATION FAMILY SERVICES, Inc.

– Office Locations –
714 Wilkins Street – Smithfield, NC 27577
214 Broadway St Suite 7 – Durham, NC 27701
401 S Market St – Benson, NC 27504

Phone: (919) 938 9502
Fax: (919) 938 9702

Email: admin@restorethefamily.org
www.restorethefamily.org

CARF 3 year accreditation for Behavioral Health: Community Integration Respite Services, Alcohol & Drug Addictions, Mental Health Services & DWI Services