Assessment Packages & Information

The primary purpose of these assessment packages is for client referral to Wilp Si’Satxw Community Healing Centre. The assessment package may also be used for referring a client to another type of agency other than a treatment Centre as it is consistent with the information collected for other National Native Alcohol & Drug Abuse Program funded treatment centres.

Please download and fill out the appropriate form with your client, then email it to Vesta Williams at v.williams@wilpchc.ca. Alternatively, you can print the form and mail or fax it.

To download, click the appropriate link for yourself to open the form, then right-click on the form and select “Save As”.

ADULT REFERRAL & ASSESSMENT PACKAGE

COLLEAGUE APPLICATION PACKAGE

ADDENDUMS - THESE MUST BE FILLED OUT TO ATTEND THIS CLINIC

CONSENT FOR TREATMENT

CONSENT FOR RELEASE OF INFORMATION

HOUSE RULES

METHADONE/SUBOXONE CONTRACT

SAFE/UNSAFE MEDICATION

YOUTH REFERRAL PACKAGE

All assessment and referral packages are filled out with the client and returned to Wilp Si’Satxw Community Healing Centre. The complete application, including pre-admission medical exam and T.B. test (only if T.B. test is positive then a chest x-ray is required), must be submitted before booking a treatment date. Clients will be booked as we receive their referral package and medical examinations by mail or by fax.

  • Applications are accepted by referral from any of the following sources:

  • Alcohol & Drug Counselors

  • Band Social Workers

  • NNADAP Workers

  • All Referral Workers

  • CHRs

  • Any Treatment or Recovery Centre

 

Please click here for guidance on writing the referral letter.