Rack Card Order Form

Axiom Care Rack Cards at No Cost to You

Order 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

Office Address(Required)
I would like rack cards for:(Required)
How many cards (of each type selected) will you need?(Required)

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.


  • 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


Contact the team directly at:

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:


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


Weapons of ANY KIND

Illicit drugs or contraband

Personal linens (linen is provided)

Outside food/ beverages (all meals and drinks are provided)

We would prefer you not bring any money or valuable items with you

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