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Patient Referrals

We specialize in outpatient treatment for individuals with primary substance use disorders.

We encourage you to refer them for a free consultation with our licensed counselor.    

 

 

We offer walk in hours for our consults Monday-Friday from 6-11am.

This consultation will assess their needs and determine if our program is the best fit for their recovery journey. 

Request Forms 

Courtesy Dosing 

Requesting Clinic must fax the forms below prior to the visit. If there was no response, please call to confirm that the fax was received. 

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Fax number is (564) 544-1928

Release of Information 

information is protected by 42 CFR Part 2, and 45 CFR which prohibits me from disclosing any information without the written permission of the persons to whom the information pertains.

Compliance Reports

 To provide compliance reports to any entities such as the courts, Indian Child Welfare, Department of Corrections, Department of Licensing and/or the Department of Social and Health Services, we must have a current copy of the court order before we will submit any compliance reports.

(per Washington Administrative Code 246-341-0640)

 

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Courtesy Dosing Policy

Dispensing Hours

Monday through Friday: 6am to 11am

Saturday: 6am to 10am 

Sunday: CLOSED

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  • Dispensing times are strictly enforced, you will not be permitted after closing.

  • Please arrive at least 30 minutes prior to closing, in case any issues arise.  

Dispensing Fee 

Individuals with Health Insurance (State or Commercial) We bill those companies for services received.

 

Individuals without coverage will be billed as follows:

Daily Rate: $10 per day

Weekly Rate: $50 per day

(We accept cash or visa, MasterCard payments) 

 

Payment Terms:

Daily Rate: Payment must be made prior to each day's dose (or in advance)​

Weekly Rate: Payments must be made in full prior to visit. 

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  • No Refunds will be issued for advance payments, regardless of whether the patients missed their scheduled dose. 

  • Patients will be notified of any remaining out of pocket expenses after insurance coverage is applied.

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Patient Responsibilities 

To ensure a smooth and efficient visit, please remember the following: 

 

Identification: Be sure to bring required identification

Lockbox: If your dispensing falls on a Saturday/holiday, you must bring your secure lockbox approved by your clinic. (Home carries will be refused without proper lockbox)

Contact Information: Ensure you have up to date contact information for your home clinic readily available in case of questions or emergencies.

Refusal of Medication: Medication dispensing may be refused under certain circumstances. This may include noncompliance with program rules or safety concerns.

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