The Recovery Council Screening form

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The Recovery Council Screening form

For additional information you may contact Admissions at 740-835-8485

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* Indicates required question

Are you interested in treatment for drug/alcohol use? *

Yes

No

If yes, please describe what you have been using, how often and when you last used *

Your answer

Please leave your name contact number, so that we can contact you to discuss options. *

Your answer

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This form was created inside of Pike County Recovery Council. Report Abuse