| To refer an individual to our program please
call during regular office hours. We will require information about the client including:
name, address, social security number, date of birth, employment/school information, drug
use history, information on any medical or psychological issues and funding information.
Concerned family members, counselors, or clients themselves are welcome
to call. Basic
steps to refer to our Program:
1. Complete an intake form. (A copy of the form may be
obtained by calling the office at 1-800-282-3323 v/tty,
1-866-928-5713 (VP), downloading
from this website, or by e-mailing the
Program) It is
important for the Program to have a complete form with detailed information so that we may
better serve or refer the client and obtain funding.
2. Mail, email, or fax the intake form to the program along with
funding information.
3. Call program staff to discuss admission. Case histories are discussed to ensure to best placement for the individual.
4. Most funding sources are accepted. For more information regarding
funding call program staff.
Additional information to be considered:
1. Admission dates and times are determined by the Program
staff with consideration being given to the clients needs and the ability of the Program
to accommodate those needs.
2. Some types of funding may require patients to make a
down payment at the time of admission. Flexible payment plans for self-pay clients and
costs not covered by insurance are available.
3. A round trip ticket is required for admission. Staff
can provide estimates of a return date to the client or client’s family. Changes to
tickets are the patient’s responsibility. It is very important not to book
transportation until all arrangements have been finalized and approved by our office.
4. Although the Program is anxious to work with family
members and referral sources, further contact following admission is possible only when
appropriate release of information forms are signed by the client.
RETURN
|
