Drug Rehab & Alcohol Treatment Center Referral     >  >  >  Call Toll Free  855-895-2315
Drug rehab and Alcohol Recovery Resources are the most important addiction help needed when someone you love is giving up their life and family to drugs or alcohol.

Drug Rehab Referral
locate a drug rehab program that will help you or you're loved one beat addiction once and for all

Alcohol Rehab Referral
find an alcoholism treatment center today and truly begin the recovery process

Drug & Alcohol Intervention
when those you love are suffering from addiction but need help finding their way to either drug rehab or alcoholism treatment an addiction intervention specialist can help

Frequently Asked Questions
quick answers to some of the most common addiction treatment questions

Site Map

Drug And Alcohol Rehab Resources Available NOW! Don't wait until it's too late
 
Client Services
Referral Follow Up
Recovery Resources
Specific Drug Types
Drug Classes
Stimulants
Depressants
Predatory Drugs
Narcotics
Club Drugs
Prescription Drugs
 
  Confidential Form
The information you provide here is held in the strictist of confidence. We do not share your information with anyone except qaulified Drug Rehabilitation Counselors or drug rehabs for which you are being considered.

  Please provide the most accurate information possible
Our consultants will attempt to assist you with the location and admission into the best possible drug treatment center available. The better the information you provide, the better the consultant will be able to narrow down the choices available throughout the nation.

Alcohol Abuse and Alcohol Treatment

Are you read to make a change in your life, or help someone you care about do the same?

We know that alcohol abuse can ruin relationships, families, careers, and the person with the alcohol problem.

You may have tried to quit drinking before, but it’s almost impossible for someone to do it on their own – despite their best intentions. Just like drugs, alcohol is an addiction. But with the right alcohol rehab center, it can be done.

Drug Rehab Referral can help save the life of a person suffering from alcohol abuse. A successful alcohol rehab program will also help restore relationships, help repair the physical, emotional and mental damage that’s been done, and help everyone concerned rebuild their lives.


Fill out this form and sent it in today,
or call us today at 1- 855-895-2315.

Talk to someone who really understands what you are going through
and can help you get a new start.


If you need help convincing someone you care about to get the help they need, we can also arrange a drug intervention to get them ready to go. The right alcohol treatment can end alcohol abuse, and give you back your life.

Your First Name:

Your Last Name:

Your Email Address:

Day Phone #:

Night Phone #:

Address:

City: State:

Postal Code:

Person you wish to help ? self other 
      If other, who are you concerned about: 

Addict's First Name:

Addict's Last Name:

Name:  Relationship:

How old is the addict ? 

Does the addict want help ? yes no 

Please list drugs abused: 
 

Primary:
   
Second:
   
Third:

Please describe the general situation with the addicted person right now.

What is the addicted person's medical history in general. (include hospitalizations, pysciatric evaluations, present time illnesses etc).

Please describe the addicted person's legal history. (include past legal charges, incarceration history and any current legal situation he / she may have).

Please list any prior treatments or drug rehab programs the addicted person has attended. ( include what type of program it was and basically what the program consisted of. Also include if the person completed the treatment program or not).




Home

Copyright © National Drug Rehab Referral Alliance, All Rights Reserved
 
Find Drug or Alcohol Rehab
Get Help Now
 
State Rehab Information

Click on the state links below to view specific state's drug rehab need data:
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
DC
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming