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Home
About Us
Our Services
- CORE
- THE NEXT STEP
Helplines
988 Lifeline
Family Resources
Make A Donation
Contact Us
- Live Chat

Online Admissions Request Form

Please complete the following and an intake specialist will contact you within one business day.

Contact Us

First name*

Last name*

Phone*

Email address*

Are you at least 18 years of age?*

Yes

No

Are you a resident of Louisiana?*

Yes

No

If not a Louisiana resident, what is your state of residency?

Which gambling treatment program are you interested in:*

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If you are experiencing an emergency, please call 911 or go to your nearest emergency room. Help is also available through our 988 Suicide and Crisis Lifeline.

Thank you for reaching out. You can expect to hear from us within 24–48 hours. If you need immediate assistance, please contact us directly at 1 (318) 424-4357

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1325 Barksdale Blvd Suite #219

Bossier City, LA 71111

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