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Who needs help?

I Do
I Do

A Loved One
A Loved One

Today
Today

Few Days
A Few Days

Within A Week
Within A Week

Within A Month
Within A Month

Drugs
Drugs

Alcohol
Alcohol

Mental Health
Mental Health

Dual Diagnosis
Dual Diagnosis

Yes
Yes I Will

No or Unsure
No or Unsure

Insurance
Private Insurance

Medicare / Medicaid
Medicare / Medicaid

No Insurance
No Insurance

Self-Pay
Self Pay

PPO
PPO

HMO
HMO

Military/Tricare
Military/Tricare

Other, Not Listed
Other

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