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What is the reason for seeking care?

Substance use Legal Requirements Relationship issues connected to addiction Trauma connected to addiction Other

What kind of care is being sought?

Individual Group IOP (Intensive Outpatient) Not sure

What Substance Use Disorder and/or concerns or treatment have occurred in the past?

Feel free to share any things you have going on that bring you to Peak Potential

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

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