Substance Abuse Outpatient Treatment Referral Form

Substance abuse treatment centers, counseling agencies, therapists, professional boards, EAPs, and others making a referral, please complete the pdf. Substance Abuse Outpatient Treatment Referral Form. Once complete, fax to (919) 833-4485 or email it to

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Affordable Alcohol & Drug Assessments


Our self-pay rates will soon be updated. Please contact our staff for more information.