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Defile GRAPHIC print DO NOT PROCESS990I As Filed Data IDLE: 934933160554951 OMB No 15450047Return of Organization Exempt From Income TaxForm201 4Under section 501 (c), 527, or 4947 (a)(1) of the Internal
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Form Betty Ford Center is a confidential form used for patients seeking treatment for substance abuse and addiction.
Patients who are seeking treatment at the Betty Ford Center are required to fill out the form.
Patients need to provide personal information, medical history, substance abuse details, and consent for treatment on the form.
The purpose of the form is to gather necessary information for the treatment of patients seeking help for substance abuse and addiction at the Betty Ford Center.
Patients must report personal information, medical history, substance abuse details, and consent for treatment on the form.
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