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Residential Treatment Financial Assistance Application

For Members of the Orthodox Jewish Community Seeking Support for Substance Use Disorder Treatment

Thank you for reaching out. Seeking treatment for substance use disorder is a courageous and important step. Our organization is committed to helping individuals and families within the Orthodox Jewish community access necessary care with dignity, compassion, and confidentiality.


This application is for financial assistance of up to $1,000 toward residential treatment services.


Please complete all sections to the best of your ability. All information will be kept strictly confidential and reviewed only by authorized staff.

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