Intake Screening Form
Application for Admission into Addiction Treatment Program
House of Hope / Stepping Stones
Download this form. This form must be completely filled out or assessment may be delayed. Be sure to ANSWER ALL QUESTIONS.
PDF Application for House of Hope and Stepping Stones
email to: firstname.lastname@example.org
or mail to:
908 SW 1st Street
Fort Lauderdale, Florida 33312
© Copyright 2022 House of Hope, all rights reserved.
House of Hope is a 501 (c)(3) non-profit recognized by the IRS. Tax ID Number: 23-7014595
Solicitation of Contributions Act Disclosure
A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling toll-free within the state. Registrations does not imply endorsement, approval, or recommendation by the state.
1-800-HELP-FLA (435-7352) www.FloridaConsumerHelp.com
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