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Are you being referred from someone else or a treatment center? *

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Who referred you?

How did you hear about BALM?

Which programs are you asking about?

I'm concerned about my loved one and want to know how you can help me

I am interested in being a coach to help families get into recovery.

I want to teach a family recovery course.

I work at a treatment center and want to know how we can work together to help families.

I'm ready to enroll, please call and let's get it done.

I'd like to learn more about your retreats.

I would like to join the BALM

I would like to re-join the BALM

I need a coach.

When is the best time to reach you? *

I'm already in the BALM and I want a coach

Yes

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