If you are feeling suicidal or feel you are at risk for hurting yourself, please dial 911 or the National Suicide Prevention Line at (800) 273 - 8255
If you are in a crisis state and need immediate help, please dial 911 for Help and do not complete form at this time. Immediate help cannot be obtained through our form system.
If you are unable to call and reach Addiction services and Pharmacotherapy (ASAP) at (608) 807 - 1428 directly during normal business hours. Please use the form to provide your confidential inquire to our admissions staff. ASAP will respond as soon as possible to your confidential message. By submitting this form and your contact information in the space's provided above, you acknowledge and consent for Addiction Services And Pharmacotherapy (ASAP) to use this information to contact you based on the information provided. All information provided remains' confidential within our facility. You may also leave your name and number on our confidential voice mail by calling our office number after office hours. Addiction Services And Pharmacotherapy assumes no liability for loss, risk or injury sustained directly or indirectly as a consequence of any actions you take with this form or our office message system. If in doubt, dial 911 for immediate help.