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BAFS Application
Application for Services & Housing
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Name
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Phone
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Email Address
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Do you have a substance use disorder that you are seeking services for?
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Referred by:
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Coos Health & Wellness
Community Corrections
Bay Area Hospital
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All services including housing are provided based on need and availability.
Services Requested (check all that apply)
Peer Mentoring
Treatment Services
Emergency Housing
Alcohol/Drug Free Housing
Health Care
Transportation
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What Agencies Are You Working With?
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You can reach us at 541-756-3111 option 2
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