If you are in crisis STOP. Call 911 or our Emergency Services Department at 239-275-4242.
How can SalusCare Help? (Please select all the below statements that apply to you.) |
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Please select or leave blank... |
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I am looking for someone to talk to about my feelings and mood. |
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I am looking for a way to manage my anger. |
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I am looking for medication for mental health. |
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I am looking for family counseling. |
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I am looking for marital counseling. |
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For my child, I am looking for ways to manage mood and behavior. |
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I am looking for help with working with my child's school. |
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I am looking for resources for myself/child/family such as food, clothing, housing, employment, accessing benefits, child activities. |
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I am looking for a way to manage my substance use. |
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I am looking for medication for substance use. |
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I am looking for a way to detox from drugs and/or alcohol. |
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I am looking for a sober living facility. |
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My child is using illegal substances. |
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I am not sure. I would like to talk to someone about my needs. |
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SECTION 1.
If unsure please leave blank
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SALUSCARE, INC. DEMOGRAPHIC FORM
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Please type DETAILED information about allergies to food or medications (If any):
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Please describe any allergic or unpleasant reactions to medications:
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Are you registered to Vote?:
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