Barnum

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Type of Request *Assisted LivingMemory CareNursing HomesCare Homes

Individual Dealing with Addiction is: *MyselfA Loved One (Adult)A Loved One (Minor)A Patient or ClientOther

Financial/Insurance Situation: *No Private Insurance or money to spendHave Private Insurance but no money to spendMedicaid/State Insurance/MedicareCan Spend $3,000-5,000/mo and Private InsuranceCan Spend $5,000-10,000/mo and Private InsuranceCan Spend $10,000+/mo and Private InsuranceNo Private Insurance But can spend $10,000+ a monthUnsure