Operational Tool Kit

The purpose of the Operational Tool Kit is to provide forms that ensures consistency, standards of practice, and reliability of decision making. 

*For outside purposes, these documents should only be considered as “examples” to be customized for unique, local approaches to diversion services.


Initial Screening Form

This form is used to screen for chemical and/or mental health concerns. It is completed by the screener, and can be used anywhere (i.e. community, pre-booking, or jail).

Release of Information - Legal

The Release of Information form is used to enable private data to be shared between the Yellow Line Project and other authorized entities who are involved with the individual. This version is specific to court involved agencies. Note: This form is to be printed on 4-layer carbon-copy paper to protect privacy while only requiring one signature from the individual.

Results and Referral Form

The Results and Referral Form is completed to summarize the Screening Form for law enforcement and the potential participant. It also serves as the official referral document from law enforcement.

Release of Information - Medical

The Release of Information form is used to enable private data to be shared between the Yellow Line Project and other authorized entities who are involved with the individual. This version is specific to medical providers. Note: This form is to be printed on 4-layer carbon-copy paper to protect privacy while only requiring one signature from the individual.

My Yellow Line Plan

The My Yellow Line Plan serves as a core document to capture specific and measurable action points for the participants. The Community Based Coordinator and participant work together to complete this form.

Privacy Rights Notice

This form is an explanation of privacy rights. Information will only be shared if allowed.

Release of Information - General

The Release of Information form is used to enable private data to be shared between the Yellow Line Project and other authorized entities who are involved with the individual. This version is used for general purposes. Note: This form is to be printed on 4-layer carbon-copy paper to protect privacy while only requiring one signature from the individual.

Release of Liability – Alcohol/Drug

This form is used to release liability/responsibility to a third party. The receiving person is agreeing to personally accept responsibility for the person who was previously detained.

Release of Information - Law Enforcement

The Release of Information form is used to enable private data to be shared between the Yellow Line Project and other authorized entities who are involved with the individual. This version is specific to law enforcement agencies. Note: This form is to be printed on 4-layer carbon-copy paper to protect privacy while only requiring one signature from the individual.

Completion Notification to Law Enforcement

When an individual completes their My Yellow Line Plan, a success letter is sent to the officer involved in the original incident.

Non-Completion Notification to Law Enforcement

In the event that an individual does not meet expectations and/or complete their My Yellow Line Plan, a letter is sent to the officer recommending the individual to be criminally charged.

Street Level Referrals - Simple
Street Level Referrals - Detailed

Archived (no longer used)

YLP Offense List

Not all individuals are eligible for the Yellow Line Project. Attached are our current offense categories.

YLP Participation Agreement / Treatment Plan

The individual, law enforcement officer, and screener must all sign the agreement to start the diversion plan. This is what we refer to as "the three yes's