Get Entry Application - Lovelady Center

This guide provides a comprehensive walkthrough for users completing the Entry Application for the Lovelady Center online. By following these steps, you can ensure that your application is filled out accurately and thoroughly.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application and open it for editing.
2. Read the intake policy carefully. Determine if you meet the eligibility criteria to become a Lovelady client, which includes age and health conditions. If you meet the criteria, indicate 'YES' and proceed; if not, provide an explanation under 'NO' and stop here.
3. If applicable, answer the question about whether you have previously been a client of The Lovelady Center. If you have, provide detailed information regarding your past participation on the indicated space.
4. Proceed to complete the personal information section. Fill in your name, today's date, date of birth, contact phone numbers, and address. Indicate your marital status and whether you have children.
5. In the legal information section, provide your AIS number, EOS date, contact information for any parole or probation officers, and any relevant court referral details.
6. Detail your drug history by listing your primary and secondary drugs of choice, along with the age you first used them. Note any previous drug treatment programs you've completed.
7. Fill out the medical information, including any diagnosed medical conditions, allergies, and insurance information. List your current medications to ensure you have a 30-day supply upon intake.
8. Complete the mental health section if applicable. List any diagnoses you have received from a qualified mental health professional.
9. Sign the agreement section, confirming that the information provided is accurate and that you understand the terms of the program and intake fee.
10. Finally, review your application for any errors or omissions. Once complete, save the application, and ensure you have a copy for your records before submitting it as instructed.

Complete your Entry Application online today to take the first step towards joining The Lovelady Center!