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  • Office: 1310 W Stewart Dr. Suite 308, Orange, CA 92868
  • (888) 268-3103
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  • About Us
    • About Rapid Detox
    • Why We’re Different
  • About Opiates
    • Signs of Addiction
    • Dangers of Opiates
    • Types of Opiates
  • About the Procedure
    • Rapid Detox Safety
    • What to Expect
    • Aftercare
  • About Us
    • About Rapid Detox
    • Why We’re Different
  • About Opiates
    • Signs of Addiction
    • Dangers of Opiates
    • Types of Opiates
  • About the Procedure
    • Rapid Detox Safety
    • What to Expect
    • Aftercare
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Home » Patient Forms

Patient Forms

Patient-Agreement

Patient Agreement

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Rights of Patients

Rights of Patients

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Patient Medical Records Request Consent Form

Patient Medical Records Request Consent Form

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HIPAA Notice of Privacy Practices

HIPAA Notice of Privacy Practices

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Patient Acceptance of Financial Responsibility

Patient Acceptance of Financial Responsibility

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Discharge Instructions

Discharge Instructions

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Notice of Physician Ownership Disclosure

Notice of Physician Ownership Disclosure

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Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements

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Notice Regarding Advance Directive Policy

Notice Regarding Advance Directive Policy

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Services provided include: phone screening & email questionnaire, pre-procedure medical evaluation (H&P, labs, EKG, chest x-ray, toxicology), medically-supervised opioid detoxification under sedation, around-the-clock monitoring during hospital stay, IV vitamin infusion (INFUVITE), Ketamine-assisted comfort protocols, residential aftercare / recovery stay, patient transportation (between care locations), and follow-up medication management after discharge.

No surgical operations are performed as part of treatment. Detoxification is a medically supervised, non-surgical process. 

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We offer a private, personalized, physician-directed approach to detox. Our 5-day program is designed for comfort, discretion, and recovery, with no compromises in care.

Offices:

  • 1310 W Stewart Dr. Suite 308, Orange, CA 92868, USA
  • 3420 Bristol Street 7th Floor, Costa Mesa, CA 92626

Patient Care:

  • Chapman Global Medical Center
    2601 E Chapman Ave Orange, CA 92869
(888) 268-3103
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Patient Forms
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