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Evaluation Questionnaire

This questionnaire is created to give the referral source, the participant and service provider an accurate description if whether or not assistance with the overcoming of substance use is necessary. 

Officers also find this service helpful to confirm the clients abstinence.

Evaluation Questionnaire Process:

  1. Enter the payment amount along with the 5.00 card processing fee.
  2. Directly following submission of payment, text your full name, email address, and last 4 digits of card used to 816-668-3380 – type ‘Evaluation Questionnaire’ in the header
  3. You will receive your enrollment information via email.
  4. Type in your information in the requested fields (read all information thoroughly).
  5. Once finished, click finish and your information will be returned to me.

    Any questions about or during the process, please call 816-492-6176.

Service fee $55

Meet YOUR FACILITATOR

Gary Dumas

Gary Dumas started his profession in human services several years ago for a reputable organization.  Gary Dumas has earned the right over his consistent years of program creation as a service provider that makes a positive contribution to the conversion of the community.  The expression that Gary uses as fuel for himself and to provoke others to make the most of each day is, 'Yesterday you said tomorrow, tomorrow is now today, so now what’s your excuse?!
Patrick Jones - Course author
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