Welcome to Summit!
If you have a Comprehensive SUD Assessment to send as a referral, please fax 612-486-8607 or email Admissions@SummitIntegratedServices.com. If you do not have any clinical documentation to send as a referral, please complete the screening form below.

We are open and happy to help Monday - Friday, 8am-4pm. Call (763) 710-7640 if you have any questions or concerns.


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NEW CLIENT SCREENING:
Please answer the questions below completely and honestly to help us connect you with the services you are looking for. 

Full Legal Name *
Date of Birth *
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Phone Number *
Email Address *
Where did you hear about Summit? *
Please check the boxes next to the additional services you would like to receive while in Intensive Outpatient Substance Use Treatment (M-Fri, 8:30am-12:30pm): *
Required
Have you ever been diagnosed with a physical health or mental health condition? If yes, please list them below. *
What has been happening in your life the past few weeks or months that has led you to Summit Recovery? *
What is your current living situation? *
What is the longest period of time that you have been able to be sober? *
What has helped you stay sober in the past? *
Required
What is your drug of choice? *
What kinds of alcohol or drugs have you consumed in the past month?  *
When was the last time you used a drug or had a drink? *
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Do you have any legal supervision such as probation, parole, CPS, or any type of commitment? *
What kind of insurance do you have? *
Required
If you have had a Comprehensive Substance Use Assessment done recently, 
please request to have it sent to ADMISSIONS@SummitIntegratedServices.com 
or fax it to 612-486-8607.

If you do not have a Comprehensive Substance Use Assessment, here are some options:

1. Text YourPath (virtual appointments only) at 
(612) 712-6879 or click the purple “message us” 
button on the website: https://yourpathhealth.org/

2. Schedule an appointment (virtual or in-person) to complete an assessment with Club Recovery by calling (952) 926-2526 or submitting your name, phone number, and email on the website:   https://clubrecoveryllc.com/schedule-my-assessment/

2. Call our Intake Department for help scheduling a Comprehensive Substance Use Assessment at Summit Integrated Services: (763) 710-7640
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(Optional) Any other information you would like to share with us?
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