info to provide when
searching for care
When reaching out to find treatment for yourself or a loved one, be prepared to provide the following information:
Personal Information
Full name, date of birth, and contact details
Emergency contact information
Substance Use History (if applicable)
Types of substances used (e.g., alcohol, opioids, stimulants)
Amount and frequency of use
Date and time of last use
History of previous treatments, if any
Mental Health History
Any diagnosed mental health conditions
Current medications and dosages
History of hospitalizations or therapy
Any self-harm or suicidal ideation history
Medical Information
Any existing medical conditions (e.g., diabetes, heart conditions)
History of seizures or withdrawal symptoms
Current medications (both mental health and medical)
Allergies or other medical concerns
Insurance Information
Insurance provider and policy number
Whether insurance covers behavioral health or substance use treatment
Financial Information
If insurance isn’t available, details of personal finances for determining potential payment plans or financial aid options
Legal Considerations (if applicable)
Any current legal issues related to substance use (e.g., DUI, court-mandated treatment)
Being prepared with this information ensures
a smoother intake process and allows treatment providers to
recommend the most appropriate care.
