In order to move forward with admission into our residential treatment program, we need you to provide us with the following documents:

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1 Dear Future Resident, BOARD OF DIRECTORS Patricia Yates Chairpersn Gilchrist Sharn Gay Vice Chairpersn Hamiltn Sharn Lngwrth Secretary Jeff Feller Jdi Irving Irma Phillips-Maxwell Timthy J. Treweek Bryan da Frta At Large Paul Metts At Large Rev. Rss Chandler Bradfrd Susan Summers Clumbia Sinma Brwn Dixie Rslyn Slater Emeritus Becky Sharpe Lafayette Jhn Martz Suwannee Debrah Grdn Unin We wuld like t thank yu fr chsing the Sid Martin Bridge Huse at Meridian Behaviral Healthcare t assist yu with yur substance abuse treatment needs. We lk frward t prviding yu with persnalized, cmprehensive care fcusing n health, recvery, and wellness. Our treatment team includes clinical staff frm a variety f backgrunds, all specializing in the treatment f addictive disrders and c-ccurring mental health cncerns. Our team includes licensed clinicians, master level cunselrs, recvery cunselrs, recvery specialist, nurses, and physicians. Our staff is dedicated and passinate abut recvery and creating a welcming and, mre imprtantly, safe envirnment in which t establish the fundatin f recvery. Our emphasis n this fundatin is what sets us apart frm ther prgrams, as we strive nt t be a quick r temprary fix, but t be a first step twards life-lng recvery. In rder t mve frward with admissin int ur residential treatment prgram, we need yu t prvide us with the fllwing dcuments: A health histry and physical exam cmpleted by a medical prvider within the last 30 days The results f a TB testing cmpleted in the last 30 days indicating yu are negative A cmplete list f all medicatins yu are currently taking (prescriptin r ver cunter) Prf f incme t determine yur cpay respnsibility. Prf f incme includes any f the fllwing: Paystub fr last 30 days Incme tax return frm the mst recent tax year Letter f benefits (fd stamps/medicaid) Prf f unemplyment Ntarized letter frm smene that has been assisting yu with fd r shelter A letter frm yu explaining why yu are seeking residential substance abuse treatment services. Please include infrmatin n yur use including substances used, age when yu started using, frequency/amunt f use, and date yu last used fr ur dctr t review. Attached yu will find infrmatin that will be helpful in preparing fr yur admissin t ur residential treatment prgram. Again we wuld like t thank yu fr chsing The Sid Martin Bridge Huse at Meridian Behaviral Healthcare t assist yu with yur treatment needs. Sincerely, Carrie C. Glebe, LMHC Directr f Residential Services Main Office: 4300 SW 13 th Street, Gainesville, FL TTY Area TTY Lcal Wellness is Within Everyne s Reach

2 Admissin t the Bridge Huse Prgram Checklist Thank yu fr yur interest in the Sid Martin Bridge Huse prgram with Meridian Behaviral Healthcare. The fllwing packet cntains everything yu need t apply fr admissin int the Bridge Huse prgram. Please read this packet carefully and cmplete all parts befre returning it t yur Admissins Cunselr. Please use the fllwing checklist t guild yur prcess. Dcuments can be submitted via , fax, r in-persn. Review the attached dcuments t insure the prgram will fit yur needs. Call Meridian s Access Center at ptin 2 between 7:30am-8pm Mnday-Friday t be screened and assigned a cunselr My cunselr is Extensin: r x5155 address: AccessCenter@MBHCI.rg Fax number: (352) Submit a recent (less than 30 days ld): Tuberculsis Test Physical If yu have a primary dctr, they can fax these recrds t (352) If yu dn t have primary dctr, yu can cntact ur Primary Clinic at (352) x8990 fr services. Let the clinic knw yu are applying t the Bridge Huse prgram and bring yur packet with yu t the appintment. Submit list f current medicatins (prescriptin r ver the cunter) Meridian Behaviral Healthcare TTY Area TTY Lcal Wellness is Within Everyne s Reach.

3 Submit a letter explaining why yu re interested in Bridge Huse; please include infrmatin n yur substance use (substances used, age when yu started using, frequency, amunt and date yu last used). Cmplete financial cunseling. This step will happen after the abve paperwrk has been submitted and apprved by ur dctr. If yu d nt receive a phne call frm a Financial Cunselr within 3 business days f submitting yur cmpleted paperwrk, cntact yur admissins cunselr. Keep updated phne number n file and make cntact every 30 days. At this pint, yu will be added t Bridge Huse s waitlist. We will cntact yu as sn as a bed becmes available. Yur cunselr has n cntrl ver bed placement. Yu will be respnsible fr keeping an updated phne number n file with us. Yu will be remved frm the waitlist if we cannt cntact yu. We lk frward t wrking with yu and thank yu again fr chsing Meridian Behaviral Healthcare. Sincerely, Access Center Team Meridian Behaviral Healthcare TTY Area TTY Lcal Wellness is Within Everyne s Reach.

4 Brief Bridge Huse Orientatin The fllwing is a brief verview and is nt intended t be a cmplete rientatin t the prgram r a review f all the rules/prcedures f the prgram. A cmplete rientatin is cmpleted during yur 1 st week f treatment. 1. There is n tbacc use allwed at Bridge Huse as we are a tbacc free prgram. There are n smke breaks and the use f tbacc and e cigarettes are nt allwed at any time. 2. Yu are encuraged t purchase nictine replacement prducts that will be held by the nurse fr yur persnal use during yur treatment. If yu cannt affrd t purchase these, please cntact the QuitLine at They will prvide yu with a 30 day supply f replacement prducts at n cst. 3. During yur first 7 days, yu are nt allwed any ff-site passes r visitrs. 4. After 7 days, passes are limited t recvery supprt and transitin planning. 5. Yu are nt allwed t have cell phnes, laptps, r tablets. 6. Yu may have a MP3 player with headphnes fr use during apprved times. 7. Yu are required t apply fr fd stamps as an individual. These stamps are fr Meridian use as allwed under the law t ffset fd csts. If yu currently have an pen case as a family, they will have t reapply separately. 8. If yu are n Subutex r any ther narctic medicatin, please be aware that the dsing prtcl fr Residential treatment is t crush the tablet prir t administratin. 9. If yu are n Subutex r any cntrlled substances and leave treatment withut successfully cmpleting the prgram, thse medicatins may held and destryed by rder f the dctr. 10. Yu are required t attend ALL treatment grups and ALL 12-Step Meetings prvided at Bridge Huse. Meridian Behaviral Healthcare TTY Area TTY Lcal Wellness is Within Everyne s Reach.

5 Things t Bring & Nt Bring Staff will search all prperty including suitcases, purses, and clthing. Fd and drinks are nt permitted. Clients are assigned shared clsets and dresser space t rganize a limited amunt f clthing and/r persnal items. If theses clsets/drawers becme vercrwded, staff will require excess clthing/persnal items be sent hme r dnated t a clthing bank. Hygiene Items Basket fr hygiene prducts Shamp/cnditiner/il Dedrant Make up in a small case (8.5x5.5x2) Unscented ltin Sap/shwer gel Tthpaste Tthbrush Alchl free muthwash Brush/cmb Hair dryer & 1 styling tl Facial cleanser/misturizer Clthing 2 3 Night gwns r pants/shirt 1 Rbe 1 pair slippers 7 10 utfits apprpriate t weather 8 10 pair f underwear 8 10 pair f scks 1 2 pair f casual shes 1 pair f sneakers 1 pair dress shes 1 pair f shwer shes 1 light weight sweater/cat 1 heavy cat/jacket (if winter) DO NOT bring clthing that is: Tight, has a lw/plunging neckline, lw rider pants, tube tps, halter tps, spaghetti straps, and/r see thrugh shirts/dresses/skirts. Sleeveless shirts/tank tps (unless they have a 2.5 r wider shulder) Shrts, skirts, and dresses that are shrter than 4 abve the knee Any clthing that is nt apprpriate will be sent hme. Persnal Items 2 4 small framed pictures 10 lse pictures r ther items fr bulletin bard Religius r Recvery reading material Hard individually wrapped candies Nictine replacement (gum, patches, r tablets) 30 day Supply MP 3 r ther small music device with earbuds Lng distance card if needed Pens, Pencils, ntebk, paper $20 in small bills fr vending machine if desired Glasses/cntacts if needed Limited small amunt f jewelry (wedding ring, earrings and single necklace) that yu will be wearing MEDICATION Bring at least a 30 day supply f all prescribed medicatins. Identificatin Please bring: FL ID r Driver s License Scial Security Card Insurance r Medicaid Card We Prvide: Sheets, blankets, pillws, twels, & wash clthes Transprtatin fr Emergency Medical, Curt (lcal), & apprved passes 3 meals plus snacks Televisin Washer/Dryer & Detergent DO NOT BRING: Cigarettes/Tbacc/E cigs Fd, drinks, sdas, r candy, etc. Over the cunter medicatin Bks, Vides, Magazines Credit Cards/Bank Cards Mre than $20 cash Perfume, clgne, after shave, scent ltins, r ther scented items Tablets, laptps, cell phnes Weapns r items that can be used as such Prngraphy Anything with drug/alchl pictures/slgans Bedding r linens Meridian Behaviral Healthcare TTY Area TTY Lcal Wellness is Within Everyne s Reach.

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