Online Evaluation

Solutions Recovery for Drug Addict and Alcoholic Confidential Online Evaluation

This online service is provided free of charge as a public benefit service and all information received from clients is confidential. Response time is usually 24 hours or less, and is in the form of a confidential e-mail. In some instances Solutions 4  Recovery services may attempt phone contact to better assess the situation or if it an extreme emergency exists and the call was requested. In the event of a phone call Solutions For Recovery services will only identify themselves to the contact person listed below, and will advise all others that this a personal call and will not disclose who we are or why we are calling.

There are several areas to be considered when assessing for substance abuse/dependence. Each of these areas creates variable factors that should be considered when making a determination for treatment and placement. Below you will find questions pertaining to these areas, it is important that you answer them as accurately as possible.

The below request for information is requested, however it is not required for a referral.

Your Name:
Day Phone #:
Evening #:
Best Time to Call:
Email:
Address:
City:
State:
Zip Code:
Your Relation to the Alcoholic/Addict:
Alcoholics/Addicts Name:
City and State in which they live:
Can they travel outside of this area for treatment?
YESNO
How old is the addict? :
Current drug (s) their using:
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