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Admissions Intake Form – Orient Wellness Center

Mission: We are passionate about healing individuals, families, and communities challenged by substance use disorders and related mental health conditions

  • RESIDENTIAL TREATMENT APPLICATION FOR PHOENIX HOUSE FLORIDA ORIENT WELLNESS CENTER - A HILLSBOROUGH COUNTY FACILITY

    Click here to apply to Hillsborough County Healthcare if you are not already enrolled
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Must Meet the Following Criteria

  • Referral Source

  • Medical Screening

  • Consent Forms

    Before we begin working with you, we are required to have your consent for evaluation, assessment and, if appropriate, treatment. Please download and upload completed versions of the below consent forms with your intake form. The review process does not begin until all required documents are received. Once all documents are received, the review process takes 24 - 48 hours.

    Download Consent for Evaluation, Assessment, and Treatment Form →
  • Max. file size: 50 MB.

Need Help?

At Phoenix House Florida, we have a passion for healing. If you or your loved one are in need of subtance use treatment, we are here to help. Give us a call or submit our appointment request form today.

Contact Us Now

How Can We Help?

At Your House

There’s no one-size-fits-all approach to recovery. Outpatient treatment must follow a continuum of care that starts with a thorough needs assessment and ends with recovery monitoring.

At Our House

For some patients, stepping away from the buzz of everyday life is the only way to make a full recovery. Inpatient treatments help patients refocus their recovery efforts to achieve positive, long-lasting outcomes.

The Derek Jeter Center

The Derek Jeter Center Adolescent program in Brandon, FL provides comprehensive outpatient services that help families deal with teen substance use and related mental health conditions.