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Offline Forms

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You may download these forms and use them when you do not have immediate access to an Internet connection. Simply take a printout and copy the relevant information onto one of these forms. You can transfer the information into the system later or hand the completed form over to other authorized users of Therap who can get the information into the system for you.


Therap Applications Offline Forms


T-Logs/Individual Data Forms

(Download these as a single .zip file)

T-Log

Individual Data Form

General Event Reports

(Download these as a single .zip file)

General Event Reports

Injury : Form-GER(a)

Witness Report (Restraint Related to Behavior)

Medication Error : Form-GER(b)

Restraint Related to Behavior : Form-GER(c)

Restraint Other : Form-GER(d)

Death : Form-GER(e)

Other : Form-GER(f)

Witness Report

Health Tracking

(Download these as a single .zip file)

Intake/Elimination Input Form

Lab Test

Seizure

Appointments

Medication History

Skin/Wound Assessment

Blood Glucose

Menses

Vital Sign

Infection Tracking

Respiratory Treatment

Height/Weight

Individualized Plan of Protective Oversight and Safeguards

(Download these as a single .zip file)

General Information

Work Center Safeguard

Residential Information

Individualized Services Safeguard

Day Program Safeguard

Information for Transportation

Supported Employment Safeguard

State Specific Offline Forms


Connecticut

Connecticut State Specific Information

Delaware

(Download these as a single .zip file)

Individual Data Form & General Event Reports for Delaware Users

IDF for Delaware Users

GER - Restraint Other for Delaware Users

GER - Injury for Delaware Users

GER - Death for Delaware Users

GER - Medication Error for Delaware Users

GER - Other for Delaware Users

GER - Restraint Related to Behavior for Delaware Users

New Mexico

(Download these as a single .zip file)

eChat (Compact Version: 25 Pages)

eChat (29 Pages)

eChat Allergies Sheet (for use with the compact eChat offline forms)

Medication Administration Assessment Tool (MAAT)

Aspiration Risk

New York

(Download these as a single .zip file)

New York State Specific Form - OPWDD 147

New York State Specific Form - OPWDD 148

Montana

Montana State Specific Information