Life Center of Galax

Request a Confidential Assessment

Assessments are provided as a free public health service and all information is held strictly confidential.
* = Required contact information.

Yes Maybe  No  
Having any problems with work or school?
Having any family or social problems?
Having any financial difficulties?
Having any legal problems?
Had any prior treatment?
     
Assessment For  
My First Name *
My Last Name *
Email Address *
Phone *
Family Member's First Name
Family Member's Last Name
Friend First Name
Friend Last Name
Coworker First Name
Coworker Last Name
Other First Name
Other Last Name
State *
Age  
Administrative Use Only. (Please leave blank) x
 
 
Home
About Us
Who Needs Help?
Why Choose Us?
Life Center Programs
Resources
Contact Us

JCAHO Drug Treatment Excellence


Home  |  About Us  |  Who Needs Help?  |  Why Choose Us?  |  Resources  |  Contact Us  |  Site Map

© 2008 CRC Health Group, Inc. | Policies, Privacy & Health Information Practices | Last Updated: 5/13/2008
Life Center of Galax Residential Treatment | 112 Painter Street | Galax, Virginia 24333
Life Center of Galax Day Treatment | 101 Doctors Parkway | Galax, Virginia 24333
ICRA accredited

Galax Recovery Center supports National Recovery Month