Get Help for Yourself
Please use this form only if you are interested in substance use treatment for yourself. If you are seeking help for a loved one, visit our Admit a Loved One form.
Taking the first step toward recovery from addiction is tough. We understand. To get started, we’ll need some information. Please provide your contact information below. One of our trained admissions staff will connect with you within 30 minutes after you submit your request unless you note to call at a desired time below. They will be able to answer your questions and help you begin the admission process. You also may call us directly at (866) 957-4960. If this is an emergency, do not use this form. Call 911 or your nearest hospital.