Residential Treatment Acceptance Letter Request Form

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If you or your loved one requires an acceptance letter for residential treatment to facilitate release from custody, please complete the form below. This letter serves as a preliminary acceptance and does not guarantee admission. All admission requirements outlined in the letter must be met. For additional important information about in-custody admissions, click here.

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Letters will be processed within 48 business hours and sent to the contact information provided in the request. If the request is denied or additional information is needed, we will contact the individual who submitted the request.

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If you are an agency representative—such as from the Public Defender's Office, District Attorney's Office, Child Protective Services (CPS), Law Enforcement, or another agency—please use our Inter-Agency Referral Form for submitting requests.

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ACCEPTANCE LETTERS ARE ONLY PROVIDED TO MEN FOR RESIDNETIAL TREATMENT. Treatment beds for women are available here: Women's Recovery Services and Athena House.

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To ensure the client receives text messages regarding their enrollment. Please check mark the "Send me marketing text messages button" if the client has a mobile phone. ​

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Need Assistance? Contact Us

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If you have any questions or need assistance, please reach out to our Admissions Team:

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Phone: (707) 360-4399

Address: 2403 Professional Drive, Santa Rosa, CA 95403

Hours: Monday through Friday, 9:00 AM to 7:00 PM​