Apply for Services

Alternative Paths, Inc.

Pre-Admission Screening Form

Please either download the form and send it in or complete the form in the fields below:

PLEASE NOTE:  If you are currently suicidal or experiencing a psychiatric crisis, immediately contact Crisis Services at (330) 725-9195.


Have you ever abused, misused or had concerns with drug and/or alcohol use?

Have you ever received drug and/or alcohol treatment (inpatient or outpatient)?

Do you have any pending legal charges and/or are you currently on Probation or Parole?

Do you have any past arrests/incarcerations/legal involvement?

Please rate the following:

My mental health symptoms prevent me from functioning at home/work.