For Immediate Treatment Help Call 1-800-610-4673

Addiction Assessment

Fill out the form below to receive a call from one of our qualified Addiction Specialists, or call us at: 1-800-610-4673 for help now!

This online service is provided free of charge, and all information received from clients is completely confidential. Response time is usually 24 hours or less in the form of a confidential e-mail or telephone interview. In most instances, a counselor will attempt phone contact to better assess the situation. In the event of a phone call, will only identify themselves to the contact person listed below and will advise all others that this is a personal call and will not disclose who we are or why we are calling. Please fill out the assessment form to the best of your ability. All fields are not required, and remember – disclosing personal information is not required for assistance or a treatment referral. Confidentiality is of the utmost importance at We’re here to help!

Note: any and all information submitted is completely confidential