Client Forms

If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.

Client Intake Form

Information Sheet

Limits of Confidentiality

 

Request an Appointment



1309 Bridgeville Hwy
Seaford, DE 19973

amokhtar@addictionmedicalfacility.com
(302) 629-2300

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