Dream Centre Intake Form
For more information or to set up an intake interview with Mac Egler please call 403-243-5598 ext. 231
Page 1: Entry Requirements
Page 2: Basic Information
Page 3: Personal History
Physical & Mental Health
Alcohol & Drug Use
Please be sure to fill out this application form completely and accurately.
Date of Birth
Eligibility Criteria (check all that apply)
Males over the age of 18, who are committed to actively working on their addictions, mental health concerns and are seeking supportive housing.
You must abstain from gambling/using drugs and alcohol for a minimum of 5 days prior to admission.
You must not have extensive physical ailments.
You must not have severe, extensive or violent criminal records.
Do Not Fill This Out