24-hour Confidential Assessment Available

We are here to help you or a loved one.

The Grove is ready to support you or a loved one on a path towards hope, healing, and positive transformation. We would love the opportunity to share details about our range of substance abuse recovery programs, built on a foundation of compassion, kindness, and hope.

Let's Talk

Confidential Contact Form

First Name*
Last Name*
Phone Number*
Email Address*
How were you referred to The Grove?
Reference*
Relationship to Client
Relationship to Client : Other*
Client Information

Please tell us about the prospective client
Client First Name
Last Name
Client Date of Birth*
YYYY slash MM slash DD
Client Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Gender Identification
Additional Comments
What substances are currently being misused by the client?*
Has the person seeking treatment been to Residential Treatment in the past 30 days?*
What type of treatment are they seeking?*
Will they be using insurance?*
- Yes
- No - Private Pay
What type of insurance does the person seeking treatment have?*
Upload a picture of the front and back of insurance card*
Drop files here or

Max. file size: 50 MB, Max. files: 2.
Additional Background on Client
Has the person seeking treatment been convicted of any sexual or violent offenses?
Does the person seeking treatment have any Mental Health or Medical Diagnoses?
Is the person seeking treatment currently prescribed any medications?

Admissions Available 24/7

Call Now

225-310-2600

The Grove Recovery Center Substance abuse recovery designed for you.

Recover at The Grove

Start your recovery journey today!

(225) 310-2600

We are here to help you or a loved one.

Let's Talk

Client Information

Additional Background on Client