Check eligibility and enroll in Affect's addiction treatment program

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We know the first step is the hardest one to take. Once you’ve made the brave decision to change your life, we make the rest as easy as possible.

Call us at 323-522-2218 or take a minute to answer a few questions below. Let’s get your recovery started.

Name*

First NameLast Name

Cell Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Date of birth*

Date

Where do you live?*

What substance do you need the most help managing?*

What is your insurance type?*

Who is your insurance provider?*

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