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5208 N. Classes Circle OK, OK 73118 Phone: 4058101766 Fax: 4058100331 OutpatientSubstance Abuse, Drug Testing, and DUI Services www.okcsos.com AMETHYST HOUSE INTAKE APPLICATION FORM General Information:
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How to fill out Amethyst House intake screening doc:
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Start by reading the instructions provided on the top of the document. These instructions will guide you through the process of completing the intake screening form.
02
Begin by entering your personal information, such as your full name, date of birth, and contact information. This is essential for identification purposes and communication.
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Move on to the section that asks about your current living situation. Provide details on whether you live alone, with family, or in a different type of housing arrangement.
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Continue by answering questions about your substance abuse history. Be honest and thorough when providing information about the substances you have used, the frequency of use, and any past treatment experiences you have had.
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Answer questions regarding your mental health history. This section helps the staff at Amethyst House understand any mental health conditions you may have and how they may impact your treatment.
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Proceed to provide information about any medical conditions or medications you are currently taking. This is important for ensuring your safety during the treatment process.
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Complete the section that asks about your legal history, including any past or current legal issues related to substance abuse or mental health.
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Lastly, review your answers to ensure accuracy and completeness. Make any necessary corrections before signing and dating the document.
Who needs Amethyst House intake screening doc:
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Individuals who are seeking treatment for substance abuse.
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Individuals who are interested in receiving services from Amethyst House.
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Individuals who want to assess their need for residential addiction treatment and support.
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