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Montana Chemical Dependency Center 525 E Mercury Street, Butte, MT 59701 Phone: 406 496 5400 Fax: 4064965437 APPLICATION FOR SERVICES: A phone interview will be conducted with the applicant and with.

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This guide provides clear and supportive instructions for filling out the Mcdc Butte Mt form online. We aim to make the application process user-friendly for all individuals seeking assistance.

Follow the steps to complete your application with ease.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your personal information in the designated fields. Fill in your name, including last, first, and maiden/middle names. Ensure to select the appropriate gender.
  3. Provide your physical address, including city, state, and zip code. If different, include your mailing address as well.
  4. Indicate your county of residence, contact numbers, and employment status. If employed, fill in the employer's information.
  5. Complete the sections regarding your education, marital status, race/ethnicity, and if you are a veteran.
  6. Fill in details of your emergency contact, including their relationship to you and their phone number.
  7. Answer questions regarding dependent children, annual family income, health insurance, and whether you receive SSD/SDI.
  8. Provide details on your current substance use, including any withdrawal symptoms you may experience, and if you have tried to address these issues previously.
  9. Complete the assessment section, which includes your physical health, any known medical issues, and current medications.
  10. For the addiction counselor section, answer questions related to your treatment history and complete the DSM-5 diagnoses if applicable.
  11. Review your information for accuracy and completeness before proceeding to save, download, print, or share the form.

Complete your application online today to begin your path to recovery.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232