Amity Circle Tree Ranch Premiere Residential Drug and Alcohol Center

Amity Circle Tree Ranch Residential Drug and Alcohol Rehabilitation Center
Residential Treatment for Drug and Alcohol Rehabilitation in Tucson Arizona, USA  |  1.800.381.3318
Confidential Inquiry for Amity Circle Tree Ranch
 

Circle Tree Ranch, an Amity Foundation Teaching and Therapeutic Community, offers an alternative to traditional alcohol and drug abuse treatment programs. With over 35 years experience providing drug addiction rehabilitation services, we are compassionate toward and committed to all individuals seeking treatment services, including those individuals who have tried other substance abuse treatment settings without success. As each person is unique, so are their treatment needs. Circle Tree Ranch offers residential addiction rehabilitation programs ranging from 90 days to 14 months or longer.

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*First Name
  
Last Name:
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You are contacting Amity Circle Tree Ranch for Drug and Alcohol Rehab referrals for:
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Drug History
What Is The Primary Drug of Abuse?  
Method of Intake:
   
What is The Secondary Drug of Abuse?  
Method of Intake:
   
At what age did the individual first take drugs?
How old is the individual now?
At what age did the individual's life begin to be unmanageable?
 
Presently What Are The Resulting Problems of The Individual's Addiction?
 
What Is The Family's Attitude Toward The Individual's Addiction?
   
Does the Individual Admit to Having a Problem? Yes No
Does the Individual want help?
Yes No
Treatment History
How Many Times Has This Individual Been in Treatment for Their Addiction?
How many of these involved the 12-Step (AA/NA model) approach to recovery?
Has there been any success with any of these treatment episodes, and if so,
what was the length of time of sobriety achieved?
 
Medical History
Does The Individual Have Any Known Medical Conditions?
If So, Please List The Condition(s) And Any Necessary Details:  
 
     
Has this individual ever been diagnosed with any psychiatric disorders?
If So, Is He / She Currently On Medication For A Psychiatric Disorder?
 
If So, Please Specify Medications Taken:
Is the individual medically and psychiatrically stable on their medication(s)?
   
Does The Individual Have Medical Insurance?
   
Does The Individual Have Legal Issues? 
   
Does the individual have any homicidal or suicidal ideations?
   
Has the individual been involved in any self-inflicting injuries or behavior?

If So, Please Describe:

  
     

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