Applications & Forms

To download a copy of the application form, click on the link below:

Application Medical Form 

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We can also help you in your search for other affordable addiction treatment telephone, affordable addiction treatment, addiction treatment programs, Teen Challenge schools, drug treatment centers or military schools. These Midwest alcohol rehab centers will specifically target alcoholism. Adult & Teen Challenge centers are long-term addiction recovery programs that are affordable, solving addictions for men in Wisconsin and Illinois, from the Chicago area, to Milwaukee and Madison, including Cudahy, South Milwaukee, Elm Grove, Butler, Brookfield, Menomonee Falls, Waukesha, Germantown, Pewaukee, Rockford.

Applications & Forms

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