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BURKE COUNCIL ON ALCOHOLISM & CHEMICAL DEPENDENCY, INC. 203 White Street, Morgantown, NC 28655 8284331221 (Phone) 8284331287 (Fax) CLIENT REFERRAL FORM Date: Client Name: Address: Phone: Age: DOB:
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How to fill out Burke Council on Alcoholism:

01
Start by obtaining the necessary forms from the Burke Council on Alcoholism. These forms can typically be found on their website or by contacting their office directly.
02
Fill out the forms with accurate and up-to-date information. This may include personal details such as name, address, contact information, and any relevant medical history or alcohol-related issues.
03
Follow the instructions provided on the forms regarding any additional documentation or supporting materials that may need to be submitted. This could include medical records, treatment history, or any legal documents related to alcohol-related incidents.
04
Ensure that all sections of the form are completed accurately and thoroughly. Double-check for any errors or missing information before submitting.
05
Once the forms are completed, submit them to the Burke Council on Alcoholism as instructed. This may involve mailing the forms or submitting them in person at their office.
06
Keep a copy of the filled-out forms for your records in case they are needed in the future.

Who needs Burke Council on Alcoholism:

01
Individuals struggling with alcohol addiction or abuse can benefit from the services provided by the Burke Council on Alcoholism. This includes those who want to seek treatment, individuals in need of support or counseling, or those required to participate in alcohol education or rehabilitation programs.
02
Families and friends of individuals dealing with alcohol-related issues can also seek assistance from the Burke Council on Alcoholism. They offer resources and support programs specifically designed to educate and help loved ones understand and navigate the challenges of alcohol addiction.
03
Additionally, healthcare professionals, educators, and community organizations may need the expertise and guidance of the Burke Council on Alcoholism to address alcohol-related matters within their professional roles. Collaboration with the council can help create educational programs, raise awareness, and establish community-wide initiatives to prevent and combat alcoholism.
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The Burke Council on Alcoholism is a local organization dedicated to addressing alcohol-related issues in the community.
Any individual or organization seeking funding or resources from the Burke Council on Alcoholism may be required to file paperwork or reports.
The required paperwork for the Burke Council on Alcoholism can typically be filled out online or through a physical form provided by the organization.
The purpose of the Burke Council on Alcoholism is to provide resources, support, and education to individuals and families affected by alcohol abuse.
Information required for reporting to the Burke Council on Alcoholism may include financial data, program outcomes, and any other relevant details about the organization's activities.
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