FAMILY QUESTIONNAIRE

Admissions

All calls are confidential with no commitment required.

Your Insurance Could Cover Addiction Treatment

Free, confidential, online verification of insurance benefits:

The following questionnaire encompasses many aspects of your life, and the life of the alcoholic/addict. Please check and comment on the items listed below as applicable to the Client’s use of alcohol/drugs and/or other mood altering chemicals.

Your comments on these questions will help us gain a more complete understanding of the Client’s circumstances. Even though some of the questions may seem obvious, it is important to keep in mind the individual may or may not be aware of his or her own past behavior or of how it has impacted your life.

Please be specific and answer every item, giving examples wherever possible.

The following information will be kept within the confines of The PAC Program and the family work done here.

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Why The PAC Program?

We’re compassionate, understanding and experienced
Our goal is your lifelong recovery from drugs and alcohol
We’ve been there - you are not alone on your journey
Holistic therapies heal co-occurring conditions
Strong community support and resources during and after treatment
Personalized drug and alcohol treatment plans designed to work

Request a Phone Call

Are you or your loved one seeking help? Let us be your guide. Fill out the form below and we will reach out to you.

FAMILY QUESTIONNAIRE

Admissions

Your Insurance Could Cover Addiction Treatment

Why The PAC Program?

Request a Phone Call

Learn More

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