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PLEASE PROVIDE US WITH THE FOLLOWING INFORMATION:
-Current phone #
-How did you hear about us?
-Current living situation
-Drug of Choice
-Date of last use
-Are you currently working a 12 step program?
-If so which one?
...AND FEEL FREE TO GIVE US A SHORT BIO AND TELL US ABOUT YOURSELF!
© 2019 Footprints to Recovery Nashville, TN
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