Quick Exit to Google

Despite COVID-19, we welcome you to submit an application. To ensure that you are healthy at the time of admission, please review the following questions:

  1. Do you have any of the below symptoms:
  • Fever
  • YESNO
  • Cough
  • YESNO
  • Shortness of Breath/Difficulty Breathing
  • YESNO
  • Sore Throat
  • YESNO
  • Runny Nose
  • YESNO
  • Feeling unwell/Fatigued
  • YESNO
  • Nausea/Vomiting/Diarrhea
  • YESNO
    1. Have you, or anyone in your household travelled outside of Canada in the last 14 days?
    YESNO
    1. Have you had close contact (face-to-face contact within 2 meters/6 feet) with someone who is ill with cough and/or fever?
    YESNO
    1. Have you, or anyone in your household been in contact in the the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19?
    YESNO

    If you are symptom free and can answer “No” to all of the questions, please submit your application.

    Application for Assessment

    If you have completed residential addiction treatment within the last year, please complete this form either online, or download the application and fax or email the form.  Also please look at our Admissions and Expectations page.

    Applicants can call us to follow up 2 days after submitting this form if they haven’t received a response (780) 426-1409.

    Thank you for completing the first part of the application process.

    We will call you or your counsellor to schedule an assessment.

    Or Download the Application

    Download the Application for Assessment

    Two Options to Submit the Application:

    1. Fax: 780-429-3459
    2. Email: intake@mcdougallhouse.com

    Applicants can call us to follow up 2 days after submitting this form if they haven’t received a response (780) 426-1409.

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