• Facilities Information Form 

    Forms for Facilities and Rehabs 

  • Where is the facility located?

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  • Are there other locations?*
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  • Do we have another other contacts at the Facility?*
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  • What types of treatment programs do you offer?*
  • Which specific conditions do you treat?*
  • What types of specialized programs do you offer?*
  • Are you Shabbat Friendly?*
  • Are you Kosher Friendly?*
  • What accreditations does your facility have *
  • Are your staff members licensed and certified in their respective fields?*
  • What types of therapies do you offer?*
  • Do you offer holistic or alternative therapies?*
  • If Yes, Which holistic or alternative therapies do you offer?*
  • Are there any additional services provided?*
  • What additional services do you provide?*
  • Do you have on-site medical professionals (e.g., doctors, nurses)?*
  • What amenities does your facility offer?*
  • What is the living arrangement like at your facilities?*
  • Is there a discount for Amudim?*
  • Is there a waiting list for admission?*
  • What other forms of payment do you accept?*
  •  Do you offer financial assistance or payment plans?*
  • Do you offer family therapy or family support groups?*
  • Do you have partnerships with other local resources for ongoing support?*
  • What languages are spoken by your staff?*
  • Is your facility accessible for individuals with disabilities?*
  • What age groups do you serve?*
  • What specific populations do you specialize in?*
  • What types of treatment programs do you offer? (Select all that apply)
  • Should be Empty: