Rack Card Order Form
Axiom Care Rack Cards at No Cost to YouOrder Rack Cards for Your Office
Order rack cards for your office to help guide your patients to Axiom Care. If they could benefit from our detox or residential care, you can offer them this resource to help them.
Fill out this quick form to order rack cards at no cost to you.
Need to make a patient referral? Fill out the form.
B2B Rack Card Order
If you would like to make a referral to Axiom Care for the Men’s RTC, please contact our intake team to check on bed availability and provide the information/documentation below.
INTAKE PACKET TO INCLUDE:
- Completed Axiom Care Referral Form
- Current Medication List
- Current ASAM
- Current Diagnosis
- Details Of Qualifying Insurance
- Current TB Test
- Paper Prescriptions
- Documentation That Client Is Medically Cleared For Residential Treatment
EMAIL TO: INTAKE@AXIOMCAREOFAZ.COM
Contact the team directly at:
602-875-0409
Once the intake packet is complete, bed availability will be confirmed, and an intake transfer will be arranged to ensure the client has a warm handoff to our facility.
For Residential SUD Treatment, the length of stay will depend on the individual needs of the clients. All treatment is regularly reviewed with the Health Plans, an Individual Service Plan (ISP) is completed and the clients are involved in all aspects of the discharge planning process.
Please read the information below on items allowed/not allowed while at the RTC:
ALLOWED
Appropriate clothing needed for 3-4 days (laundry services on site)
Personal hygiene/ toiletry items
Current photo ID
Insurance card
List of prescribed medications
Details of current health care and mental health care providers
NOT ALLOWED