Make A Referral

Information for Referring Professionals
It’s as easy as one phone call to 1-888-525-9771 for a telephone screening to start the intake process!

Last Door Adolescent Program and Adult Program helps Professionals deliver the best outcomes for their clients and patients with alcohol, drug, gambling, prescription medications, nicotine and video gaming addictions.

When your client or patient’s assessment indicates that Intensive Clinically Managed Residential In-Patient Treatment is needed for recovery, Last Door can provide an individualized treatment plan. Working closely with you throughout the intake process for easy access to clinical, psychological, and spiritual care.

Please download the appropriate from and fax the completed referral forms to the fax numbers provided on the forms.

Adolescent Forms

Please return these forms to

Adult Intake Forms

Please return these forms to

Intake Processes vary case by case due to bed availability and funding, Please call our helpline with any questions you may have.

Last Door also uses a state of the art Electronic health Record System, capable of providing you with progress reports throughout the clients stay.

Minimum stay at Last Door is 90 days with most clients staying 4 to 5 months, some clients take advantage of our longer term Continuing Care Program that allows clients to stay up to two years while returning to work or completing their education.

To learn more about the Clinical Benefits of Last Door’s Longer term treatment program please visit here