Confidential Assessment Form


 

 

A New Beginning Starts Here.

Accepting Patients for the Treatment of Opioid & Narcotic Dependence.

Confidential Assessment Form

This assessment is provided as a free public health service. A licensed alcohol and drug provider reviews all responses, and all information is strictly confidential..

(*) = This indicates required information on the questions that follow
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We are a specialty clinic for opioid dependency. Additional referrals may be necessary if your drug of choice is not an opioid.
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