Please use this form to tell us how we can help you or ask questions about our drug and alcohol center. Please remember to leave a valid phone number where you can be reached, a preferred time to call you, and an alternative number if possible so that we can assist you as promptly as possible. We WANT to assist you or your loved one right away.
Addiction Treatment Program Registration
If you feel you’re ready to take or help your loved one take steps towards recovery, download Footprints in Recovery Application Questionnaire. Once you’ve downloaded it and completed it, email it to us at info@footprintsinrecovery.com and we’ll get back to you as soon as possible. If you are in need of immediate assistance, you can also fax it to us at 252-441-8248 for faster processing. Please do not hesitate to call us as this is the fastest way to have someone discuss entrance to our drug and alcohol rehab treatment.