Medical Assessment

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Medical and Psychiatric History

Please select either “Yes ” or “No” or “X” for “Don’t know”. Answer all questions.


Please provide the name, age and address of the adult who has agreed to supervise your medication, should you be issued with a prescription.

Read the Stories
Of Recovery

How We Help Them

We know that it is vital to view our patients as individuals and to offer a safe and kind environment that helps to support their healing journey.

Recovery stories