For Families B2B Residency Application

Back2Basics Residential Treatment Center Application

In order to apply for residency with Back2Basics click on the following Residential Treatment Admission form, download it, fill it out and fax it to our office at (928) 213-5838.

Back2Basics Residential Treatment Admission form (PDF format).
Back2Basics Residential Treatment Admission form (MS Word format).

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