Getting in touch with a Treatment Resources coordinator is never been easier. Our toll free helpline is available 24 hours a day. If for some reason you reach our answering service, you can leave your name and were to reach you on our confidential voice mail. A treatment resources coordinator will contact you within 30 minutes.

You can also email us at info@treatment-resources.com we will respond to your email within 24 hours. Or you can fill out the form below. We will assist you within 1 to 12 hours.

Please provide the following contact information:
First Name:
Last Name:
Date of Birth:
Sex:	Male Female
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Work Phone:
Home Phone:
Email:
Select any of the following that apply:
Mental Health Concern Psychiatric Stabilization Substance Abuse Evaluation Detoxification Residential Treatment Long Term Treatment Outpatient Care Halfway House Recovery Home
Select any of the following that apply:
Non Compliant with Medication Rx Medication Alcohol Amphetamines Benzodiazepines Cannabis Cocaine Crack Inhalants Opiates Hallucinogens Ecstacy/GHB
Type of Insurance Coverage:
PPO HMO Private Healthcare Government Sponsored Medicare Medicaid Self Pay Blue Cross Blue Shield
Insurance or Other Information: