Good day!

Please faithfully follow the following guidelines in filling-out the CBDRP Reporting Form 1

A. LGU
1. In Column C, kindly indicate your City/Municipality as the first entry, followed by your respective barangays.
2. Kindly indicate in Column D "1" if there is existing DOH-certified CBDRP and "0" if there is none.
3. If there are no surrenderers or if the LGU is drug-free or drug-cleared, please indicate "1" if there is a CBDRP Plan ready sho

Note: Please know that there is a separate CBDRP for City/Municipal and for Barangays. As per the JMC, all cities/municipalities should have
CBDRPs, while for barangays, it is optional, considering the need thereof and the capacity of the barangay. All CBDRPs should be certified by the
DOH as per DDB BR 4 2020 before implementation.

B. Participants
1. In Column F, kindly indicate the total no. of surrenderers for the quarter being covered
2. In Column G, kindly indicate the total no. of CBDRP participants that are new to the program
3. In Column H, kindly indicate the total no. of CBDRP participants that were once admitted to the program but stopped, then
4. In Column I, kindly indicate the total no. of CBDRP participants who completed the program during the quarter being covere

C. Referral
1. In Column K, kindly indicate the total no. of clients with Low Risk and were referred to General Intervention
2. In Column L, kindly indicate the total no. of clients with Moderate Risk/MILD SUD and were referred to CBDRP
3. In Column M, kindly indicate the total no. of clients with Moderate SUD and were referred to out-patient facility/program
4. In Column N, kindly indicate the total no. of clients with Severe SUD and were referred to in-patient facility/program
4. In Column O, kindly indicate the total no. of clients with risk and co-occuring psychiatric/medical comorbidity and were refe

Note: The total number in column L should be the same with the sum of the total number in column G and H.

Column L = Column G +
(Total no. of CBDRP Participants) (New CBDRP Participants) (Readmitted/Old CBDRP Participa

Note: The total number in column F should be the same with the sum of the total number in column K, L, M, N, and O.

Column F = Column K + Column L

Total no. of Surrenderees (GI Participants) (CBDRP Participants)

D. CBDRP Interventions
1. In Columns Q-AA, kindly indicate "1" if the intervention is being implemented and "0" if there is no available intervention in

Note: Please do not encode the total no. of participants in each intervention, just kindly encode "1" if the intervention is available and "0" if not.
 tive barangays.

here is a CBDRP Plan ready should the need arise, and "0" if there is none.

municipalities should have

s should be certified by the

he program but stopped, then presented themselves again to continue the program
during the quarter being covered

al Intervention
eferred to CBDRP
out-patient facility/program
patient facility/program
ical comorbidity and were referred to mental health facilty/medical professionals

G and H.

Column H
(Readmitted/Old CBDRP Participants)

, M, N, and O.

Column L + Column M + Column N + Column O

(CBDRP Participants) (Out-patient clients) (In-patient clients) (Clients referred to Mental Health Facilities)

e is no available intervention in the LGU

is available and "0" if not.

 Column O
erred to Mental Health Facilities)
CBDRP REPORTING FORM 1
COMMUNITY-BASED DRUG REHABILITATION PROGRAM
Municipality of Guimba
Province of Nueva Ecija
Region III
2ND Quarter of 2024

Participants

With DOH
Barangay certified
CBDRP? Total no. of
Total no. of new Total no. of clients
Total no. of readmitted Total no. of
CBDRP referred to General
surrenderer CBDRP graduates
participants Interventions
participants

0 0 0 0 0 0
SAINT JOHN
DISTRICT

Total 0 0 0 0 0 0

Prepared and submitted by:

IGNACIO G. SEBASTIAN
Barangay Secretary
ROGRAM QUARTERLY REPORT
ba
ja

Referral
Community-based Treatment
Community-based Su
Services

Total no. of Total no. of Total no. of Medication- Health Services

Total no. of Spirituality and
clients referred clients referred clients referred to assisted and Wellness
clients referred moral recovery
to Out-patient to In-patient mental health Treatment, Promotion
to CBDRP programs
facility facility facility Detoxification Programs

0 0 0 0 0 0 0

0 0 0 0 0 0 0

Noted by:

LINA CORAZON E. GARAMPIL

Punong Barangay
 Community-based Drug Rehabilitation Program Interventions

unity-based Support Services Aftercare Interventions Reintegration Services

Life Skills Training,

Community
Vocational Skills Family
Individual, Literacy and Relapse service, Civic
Psychoeducatio training, Livelihood, relationship
Group and Educational management and
n/psychosocial Micro_Credit, restoration
Family Programs or and early Environment
support Employment and Other sessions and
Counselling support recovery skills Awareness
Support for Income counselling
programs
Generation

0 0 0 0 0 0 0

0 0 0 0 0 0 0
on Services

Preventive Drug
Education,
community-
reconciliation
sessions or
community
information
sessions