drug rehab
drug rehab centers  
     
  alcoholism    

 

Our Counselors are ready to help you find the best drug treatment facility in or outside of Texas.

Help is just a toll free call away for Texas drug rehabilitation centers. Dont wait until it is too late sometimes the bottom is too far to fall.Our drug and alcohol treatment facilities staff will guide you or someone you love


 

 

TEXAS DRUG REHAB CENTERS  

on-line assessment 

Alcohol Rehab and Drug Rehab
Drug Treatment Centers

CONFIDENTIALITY & SECURITY POLICY
Our Staff and its operating programs have a primary policy and responsibility to strictly adhere to protecting the security and confidentiality of its clientís/patientís personal health information. Our  staff will not release any information without a specified written consent from the client/patient and/or only if such disclosure is permitted under legally concise elements of current federal laws including:
  • CFR Part 2                              

 

Each staff member is dedicated to upholding these standards in all verbal, written or electronically transmitted communications and records. All staff sign a confidentiality agreement to safeguard patient/client identity and other personal protected health information.

 

  Texas  Drug treatment facility online assessment service will help us in determining the best possible drug treatment solution based on the information provided. The more information that is provided the better we can serve you and help us in the process of locating the drug rehab that is right for you. Response is usually 24 hours or less. if this is urgent please call our toll free number and we will help you find a drug rehabilitation facility that will best suit the individual needs of the person needing help.    


   



Contact information: Fill out the Form below and we will Contact you ASAP.
 Your Name, First & Last
 Your Phone Number and area code
My e-mail address is:
Best time to call is, am  pm: Pacific-time, Mountain-time, Central-time, Eastern-time:
A). Medical History:

drugs and alcohol addictionDoes the individual have any medical problems? (Please describe)
     

drugs and alcohol addiction Is the individual currently taking any medications?  yes  no

     If yes, please specify what and length of use:
     

B). Legal History:

drugs and alcohol addictionDoes the individual have a valid drivers license?  yes  no

drugs and alcohol addictionHas the individual ever been arrested? (If so, for what)
     

drugs and alcohol addictionAre any crimes actively being committed to support, or as a result of the alcoholism or addiction?
     

C). Substance Abuse History:

drugs and alcohol addictionAt what age did the individual start using the substance?:

     

drugs and alcohol addictionDifferent drugs used:
     

drugs and alcohol addictionMethod of use:  
       Oral     IV-(Inject)     inhale(Smoke)     nasal(Snort)     Other

drugs and alcohol addictionPast treatment attempts (What rehab, when, results:
      

D). General Contact Information: 

drugs and alcohol addictionYour Relation to the Alcoholic/Addict:

drugs and alcohol addictionAlcoholics/Addicts Name:

drugs and alcohol addictionCity and State in which they live:

drugs and alcohol addictionCan they travel outside of this area for treatment?  yes  no

drugs and alcohol addictionHow old is the addict ?

drugs and alcohol addictionCurrent drug (s) their using:
     

Question/Comment/How can we help you:

All content on this web site is Copyright © 2003 - 2014  Texas Drug Rehab Helpline


 

 

 

 

drug rehab centers  Texas Crystal Meth problem 
Methamphetamine addiction in Texas is becoming common place in most communities in Texas. more families than ever before are affected by this.


Texas families can overcome this problem, drug addiction treatment is the first step in recovery.
 

           

 

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