Get Help for A Loved One
Please use this form only if you are interested in addiction treatment for a loved one. If you are seeking help for yourself, visit our Admit Yourself form.
To get started, we’ll need some information. Please provide your contact information below. One of our admissions staff will connect with you within 30 minutes of your inquiry unless you note to call at a desired time below. They will be able to answer your questions and begin the admission process for your loved one. You also may call us directly at (866) 704-7692. If this is an emergency, do not use this form. Call 911 or your nearest hospital.