Talk Directly to an Intake Counselor of Adult & Teen Challenge by Calling (855) 934-4673, or Request an Appointment Using the Confidential Form Below…

** This is a secure page. All information is kept confidential and never shared or sold. Please include only your own contact information. If someone else needs help, do not send us their contact information, since they will not know who we are or why we are contacting them. **

Adult PROGRAM INQUIRIES ONLY (for teenage boy rehab inquiries, use the lower section):

YES! I'd Like More Information ...

Contact information below is for myself, NOT someone else.

Information of Person Needing Help:

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  • This form is for intake inquiries and questions only! Business solicitations are not welcomed and will not be answered. DO NOT submit this form with someone else's contact information.

 

Recovery Help For Teenage Boys

** This is a secure page. All information is kept confidential and never shared or sold. **

YES, I am Interested in Getting Help for My Teenage Boy. Please Call Me ...

Prospective Resident Information

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  • This form is for intake inquiries and questions only! Business solicitations are not welcomed and will not be answered.