Intervention Services
Recovery Support Services
Aftercare Services
Name
Tel
Email
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Recovery Support Services
- $0.00
Recovery Coach 1 Session $75.00
Case Assessment $275.00
Treatment Coordination $375.00
Sober Transportation 1 $100.00
Sober Transportation 2 $375.00
Sober Transportation 3 $500.00
Intervention 1 $1,500.00
Intervention 2 $2,500.00
Intervention 3 $3,500.00
Your First & Last Name
Online Assessment
Complete the questions below for your Free Online Assessment:
Have you ever told lies to cover up someoneelse's alcohol or drug use?
Yes
No
Do you ever threaten a loved one with threatssuch as, "If you don't stop drinking or using drugs, I'll leave you"or "....I'll kick you out"?
Yes
No
Have you been hurt, scared or embarrassed by adrinker's or a drug addict's behavior?
Yes
No
Do you feel like a failure because you can'tcontrol the drinking or drug use of a loved one?
Yes
No
Do you feel angry, confused, scared or depressedmost of the time due to a loved ones drug or alcohol problem?
Yes
No
Do you feel there is no one who understands your problems?
Yes
No
Have you refused social invitations out of fear or anxiety that your loved one's behavior may be unpredictable due to drinking or drugs?
Yes
No
Do you have a loved one who has suddenly lost a lot of weight or sometimes sleeps for days at a time?
Yes
No
Does a loved one or coworker get angry or defensive when you discuss the topic of their addiction?
Yes
No
Do you have a coworker or employee who frequently misses work or is performing poorly due to a suspected problem with drugs or alcohol?
Yes
No
Have you thought about reporting or firing an employee who you suspect is abusing drugs?
Yes
No
Do you worry about how much or how often someoneelse drinks or uses drugs?
Yes
No
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