Addiction Recovery Programs at Sierra Tucson
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If you prefer to print and fax your application, please click on the link below to download a printable version.

Printable Resource Application (PDF)

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 Resource Application

To be listed in the Professional Resources Network on Sierra Tucson's website, please complete and submit this form.*
Resource Type: Physician   Therapist   Interventionist   Continuing Care Facility
First Name:
Middle Initial:
Last Name & Credentials:
Organization:
(If organization is provided, you will be listed by your organization name.)
Years In Practice: years
Qualifications:
Description of Services:
Address:
City:
State:
Zip:
Country:
Phone:
Phone 2:
Fax:
E-mail:
Website:
Specialty Areas:
Trauma Eating Disorders CD/Alcoholism Sexual Addiction
Axis II Disorders Compulsive Gambling Internet Addiction Mood Disorders
Other (Please Describe):  
Modalities:
Children Adolescent Family Acupuncture
Individual Group Interventions Couples
Psychodrama EMDR Somatic Experiencing Experiential
Imago Therapy Massage Reiki Chiropractic
DBT Other (Please Describe):  
Type of Service:
Acute Care Inpatient/Hospital Residential Extended Care
Halfway House Partial Hosp/Day Program IOP Outpatient
Recovery Living Other (Please Describe):  
Fee Range:
Length of Stay:
Accepted forms of payment:
Medicare Insurance Private Pay
Please describe your philosophy in 50 words or less:
By submitting this form online, I hereby authorize Sierra Tucson to include the above information on their database and to publish such information on Sierra Tucson's website. I also agree to receive information or contact by Sierra Tucson.
Sierra Tucson, Inc.
39580 S. Lago del Oro Parkway
Tucson, AZ 85739
Fax: 520-818-5869
Telephone: 800-842-4487
*Note: Please be advised that Sierra Tucson will evaluate all submissions and will retain the right to add or subtract listings from the Sierra Tucson website at their discretion. Submission of this form does not guarantee inclusion on Sierra Tucson's website. Sierra Tucson cannot be held liable for the accuracy of information submitted or displayed. Applicant agrees to release and hold harmless Sierra Tucson and all of its subsidiaries, owners, officers, directors, employees, and agents from any and all liability relating to the use of any information contained herein.

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Toll-free from U.S.A.: 1-800-842-4487
Freephone from U.K.: 0800 891166

© Copyright 2006 Sierra Tucson, Inc. - Since 1983, Sierra Tucson has grown from a drug rehab center to a comprehensive inpatient treatment facility. We help individuals and families overcome addiction and behavioral disorders and rebuild their lives. Recovery means a better way of life!