- Our mission is to educate on opiate and drug use. We are able to provide support and help to the families of addicts. This non-profit organization is in honor of Andrew Michael Hirst who passed away from a Heroin overdose on May 17th, 2010. Our board will review this application and get back to you in a timely manner.
Inpatient, Outpatient, counseling, amount of time spent in the treatment and dates provided.
Please name the treatment program, where it is located and when the treatment began.
Example: Financially, Emotionally
Example: Dollar amount, percentage, Support group,
Tell us how your addiction began, the struggles you have faced with addiction, the emotions tied to your choices, etc..
Name of parent/legal guardian, Address, City, State, Zip, Phone, Email.