Referral Intake Form 

Westminster House welcomes individuals who satisfy the following requirements:

• Youth or adult who identifies as a female

• You currently have a negative relationship with drugs and/or alcohol

• Chemical (this includes alcohol) substance misuse is your primary diagnosis

• You have funding in place

• You are prepared to become a non-smoker/vaper for the duration of your stay (we offer nicotine patches)

• Agree to adhere to Westminster House Primary Care Guidelines

If you are satisfied with the above-noted requirements, please call Westminster House offices and request to be added to our waitlist. If there are special circumstances surrounding one of our criteria, please call and discuss it with our trained intake workers. We are willing to work with you to help you succeed in your desire for recovery.

 

If you or a loved one requires assistance, please contact one of our intake staff. Our highly qualified team is ready to assist you and all information is kept confidential.