Get Help I would like to find out how to get help!* Indicates required field Name * First Name Last Name Email * Phone * (###) ### #### Do you have children? Yes No Are you currently pregnant? Yes No Was your child born drug dependent? Yes No Test positive in hospital? What drug? Do you have children in DCS custody? Yes No Are you actively using? Yes No How long have you been using? Can you attend Monday, Wednesday, and Friday? Yes No Do you have transportation? Yes No Comment * Thank you! We will be in touch soon. If this is an emergency, please call 911 or go to the emergency room at the nearest hospital.
