New At Serenity: Discover Our 3.1 Residential Treatment Program Today!
WEBSITE CONTACT FORMS ARE CURRENTLY DOWN – Please call or email to contact us. Thank you!
- Frederick & Hagerstown
- info@serenitytreatmentcenter.com
Level 3.1 Referrals
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3.1 Residential Treatment Program
Online Referral Form
Thank you for your interest in our residential treatment program. Please read all of these instructions completely before filling out our convenient online form.
If you’d prefer to download and print the form, click here.
The following items must also be submitted to the Serenity Treatment Center Admissions Team as part of the application process:
For convenience, you will have the option to upload the files directly to the form, or you can choose to email or fax them separately.
- A copy of the patient’s most recent TB skin test result, or Chest X-ray, TB results or Chest X-ray cannot be more than 12 months old (If applicable).
- A recent clinical evaluation such as a Biopsychosocial or Substance Use Disorder Assessment.
- A Psychiatric Evaluation and/or History and Physical (if available).
A copy of the patient’s COVID-19 vaccination record (If applicable).
If you have questions about this application or prefer to submit the required documents separately via email or fax, please use the contact info below:
Phone
(301) 898-2627
info@serenitytreatmentcenter.com
Fax
(301) 898-2640
Address
1313 Butterfly Lane Frederick, MD 21703
Prescreen Application for Level 3.1 Residential Treatment
Please fill out the form below, completing all sections. If a question does not apply, please type N/A. Once you submit the form, you’ll receive a confirmation email to the email address you provide.