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1-250-849-5211
Referral Letter
PLEASE USE THE FOLLOWING GUIDELINES TO WRITE YOUR REFERRAL LETTER
Readiness for Healing Program:
A – Present emotional health
B – Why now?
C – Previous Treatment or Healing Program?
Alcohol and Drug History
Relationships
What resources does Applicant have?
Healing Program Goals?
Referred by:
Name:
Address:
Telephone:
Relationship to Applicant:
Employer
Counsellor
A.A., Sponsor
Physician
Probation Officer
Other (Specify)
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