Ready to consider our program?

Considering treatment for your son is a very difficult situation. We have talked with thousands of parents from all over the United States over the years, and we want you to know that we are in your corner.

Fully State Licensed

The first step:

Applicant Screening & Mental Health History

Please start the process by filling out the Applicant Screening & Mental Health History Form. This form will help us to understand more about your son’s situation and see if our program is the right fit for him. It is imperative that we have a detailed history of your son’s mental health/drug use prior to his arrival. If your son qualifies for health insurance benefits, we need as much detail as possible in presenting the severity of your son’s addiction. The burden of proof of medical necessity for treatment falls on us.

If you prefer to talk with us to begin this process, please call 770.869.3551.

Applicant Screening Information

Name

Birthdate

Address

Phone

Parent's Name

What is your son's attitude about getting help?

Does your son have issues with drugs? If so, please explain

Has your son seen any of the following:

Psychiatrist Psychologist Counselor None

Is your son currently on any medication? If so, please list all medications he is currently taking.

Is your son on Probation?

Please list all Probation Officer information.

What is your son's current grade level?

What has led you to consider treatment for your son?

How did you hear about 3D Teen Recovery? If you were referred by someone or an organization, please tell us who:

Applicant Health & Medical History

If you have health insurance, what is the name of your insurance company/provider?

History of Mental Health Treatment*

Include any & all inpatient hospitalizations, length of stay, reason for admit, & diagnoses. Any attempts to self harm in any capacity & when the attempts occurred.

Behavioral Problems

Problems at home, problems at school, problems with other activities, changes in behavior

History of Drug Use

Legal & Drug/Alcohol Use - Include date of first use and last use of each substance, duration of use, and how often. Example: My son began his use when he 12 years old when he took some beer out of the fridge. He didn’t start using consistently until 14. We started finding empty beer bottles under his bed; he brought a water bottle of vodka to school and was expelled in September 2015. His last date of use was last weekend when he went to a party and drank enough to pass out. We couldn’t wake him up and he was sick then next day.

Additional

Health Documents

Evaluations, Diagnoses, Intake Evaluations

Court/Probation Documents

Current/Previous Charges, Probation Violations, etc...

IMPORTANT!

Please note that if your son has insurance, it is IMPERATIVE that you provide as much detail as possible in presenting the severity of your son’s addiction. The burden of proof of medical necessity for treatment falls on us - this means that the insurance company can deny coverage if they feel your son’s “presenting issue” doesn’t meet THEIR criterion. So we want to cover every angle to leave them with no reason to deny coverage. Include your subjective opinions as well as specific changes in behaviors that you have noticed in the course of your son’s addiction.

Recovery Home
4141 Old Cornelia Hwy
Gainesville, GA 30507

Phone
(770) 869-3551

Ready to consider our program?

Considering treatment for your son is a very difficult situation. We have talked with thousands of parents from all over the United States over the years, and we want you to know that we are in your corner.

Fully State Licensed

The first step:

Applicant Screening & Mental Health History

Applicant Screening Information

Applicant Health & Medical History

IMPORTANT!

Address List

Social Networks

Links List

Address List

Social Networks

Links List

Please join us and support our boys at our Shoot For A Better Life Event!

Recovery Home 4141 Old Cornelia Hwy Gainesville, GA 30507

Phone (770) 869-3551

Ready to consider our program?

Considering treatment for your son is a very difficult situation. We have talked with thousands of parents from all over the United States over the years, and we want you to know that we are in your corner.

Fully State Licensed

The first step:

Applicant Screening & Mental Health History

Applicant Screening Information

Applicant Health & Medical History

IMPORTANT!

Address List

Social Networks

Links List

Address List

Social Networks

Links List

Please join us and support our boys at our Shoot For A Better Life Event!

Recovery Home
4141 Old Cornelia Hwy
Gainesville, GA 30507

Phone
(770) 869-3551