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3500 Touché Street, Suite 240A | Anchorage, AK 99508 | Phone (907) 2764611 | FAX (907) 2585167New Patient OUT Questionnaire
Name___ Date___
How did you hear about us? ___
What brings you to treatment
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Set alaskasubstance abuse treatmentalcohol is a form required for reporting substance abuse treatment and alcohol-related information in Alaska.
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Information such as types of treatments offered, number of patients served, outcomes of treatment, and any alcohol-related incidents must be reported on set alaskasubstance abuse treatmentalcohol.
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