Payment

Please send payment only after receiving confirmation from our staff. You can apply here or browse our site to learn more about our residential recovery program and outpatient services.

First Name*

Last Name*

Phone Number*

Service*

Residential Recovery Program Genesis Process Group Individual Genesis Session (1 hour) Outpatient Package 1 Outpatient Package 2

Amount* $  

Upon submission, you will be redirected to PayPal to complete your payment securely.