Let’s Get Started
Before completing the Residential Interest Form, please review our treatment details and FAQs (Frequently Asked Questions) to ensure residential treatment is the right option for you. This information can be found on the residential treatment page.
Please fill out the secure Residential Interest Form below. Be prepared with medication, physical health, mental health and legal information for the person interested in residential treatment. Please be assured that this referral will be handled in a way that respects the patient’s privacy and complies with HIPAA regulations.
After you complete the Residential Interest Form our care team will review all the information and will reach out if additional information is needed. Our care team will then contact you to discuss next steps regarding admission to our residential program. Treatment is the first step in recovery.
For more information or questions please contact our care team.