GET HELP NOW – (724) 465-2165
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(724) 349-1528
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Admissions Inquiry
The “Admissions Inquiry” form lets you easily request information or inquire about treatment without the need to call us directly. If you submit your request during normal business hours, our team will return your call before admissions closes for the day, although the call may come from a different number. For immediate assistance, you can also reach us directly at 724-465-2165 and press option 1 twice. Please note: If you are seeking Methadone Maintenance, you must have a home clinic prior to treatment at SpiritLife. Let our admissions staff know if you need help finding a clinic.
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Please enable JavaScript in your browser to complete this form.
Have you ever been to SpiritLife before?
*
Yes
No
Unsure
What level of care are you seeking?
*
Inpatient Rehab [3.5]
Inpatient Rehab [3.5]
Inpatient Withdrawal Management [3.7WM]
Both [3.7WM then step-down to 3.5]
Other (Please discuss with admissions coordinator during callback.)
Name
*
First
Last
details can medicated
Phone Number
*
Email
*
Email
Confirm Email
When are you looking to come in for treatment?
*
Today
Tomorrow
Not sure/Later
Do you currently know someone that is currently in treatment at SpiritLife now?
*
Yes
No
At SpiritLife, we prioritize creating a safe, supportive, and focused environment for all clients. For this reason, we do not permit romantic, sexual, or any other personal relationships between clients during treatment. Such relationships can distract from the healing process, create unnecessary stress, and potentially undermine the therapeutic goals of recovery. Our commitment is to help clients work through their challenges in a respectful and focused environment, where they can fully engage in their treatment and recovery journey.
Which PA County is your insurance registered in?
*
Are you currently on any medicated assisted treatments (MAT)?
*
I am not currently on any medicated assisted treatments.
I am not currently on any medicated assisted treatments.
Methadone (Must have established Home Clinic.)
Buprenorphine
Suboxone
Subutex
Sublocade
Naltrexone
Vivitrol
Acamprosate
Disulfiram
Topiramate
Modafinil
Mirtazapine
Something else.
We ask for specific details on MAT dosing to ensure we can safely and effectively support each client’s medical needs during treatment. Having accurate MAT information helps our team monitor withdrawal symptoms, prevent potential interactions, and make any necessary adjustments to create a safe and comfortable recovery environment.
Insurance/Funding Type:
*
Medicaid
UPMC Health Plan (Commercial)
Highmark BCBS (Commercial)
Armstrong County SCA Funding (AICDAC)
Indiana County SCA Funding (AICDAC)
Clarion County SCA Funding (AICDAC)
Butler County SCA
Cambria County SCA
Westmoreland County SCA (WeDAC)
Washington County SCA (WDAC)
I do not have insurance.
Are there any other details you can provide?
Additional information may include details about medical and mental health conditions, Medication-Assisted Treatment (MAT) dosing, potential barriers to treatment, and individual motivations for seeking recovery.
Submit Inquiry
“It does not matter how slowly you go, as long as you do not stop.” –
Confucius
Treatment Services and Other Information