Residential Substance Use Disorder Treatment for Women



Date:___________________________


Re:___________________________________________

                           (Your Name)

DOB:__________________________________________


Dear DSS Caseworker:

The above named has applied for admittance to our facility:

New Hope Manor

35 Hillside Road

Barryville, NY 12719


New Hope Manor is a Residential Rehab and Congregate Care II housing for substance use disorders for women and their children.


As part of our intake process we require that all of our referrals apply for DSS approval for out of county long term substance use disorder treatment/ Temporary Assistance from their home county before they arrive for treatment.   This client is here today to begin this application.


Please also provide proof (document sheet or letter) that the above named has out of county approval, has applied for TA and provide the name of a contact person and phone and fax number.  We will send a Shelter form and Admission letter to this contact on date of admission.  We will also follow up with any other required documents.


If you have any questions please do not hesitate to contact Lisa Geoghan: (845) 557-8353 x 339   fax: (845) 557-6603.


Sincerely,


Lia Martucci

Lia Martucci

Admissions Specialist









Hillside Rd, Barryville NY 12719Ph: 845-557-8353     Admissions Fax 845-557-3541www.newhopemanor.org