Addiction Treatment Placement Assessment

The free assessment form is provided free of charge to the public as part of an ongoing ministry to help Christians recover their lives from the grips of addiction. This assessment form is provided to help us guide you to the best Christian treatment center for addiction. Please feel free to fill out as much or as little as you feel comfortable with.

All information provided on our forms is strictly confidential and will be only used to help you get placed into a drug treatment facility.

The information submitted is protected under The Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Please allow 1-2 days for a call back from one of our trained and certified Christian treatment specialists. For immediate service call now.

Call 1-800-303-4833 24/7 Services
or fill out our contact form HERE