Spouse or parents Information

Emergency Contact Information

Reason why you are here.

YOU MUST BE DETOXED PRIOR TO COMING TO BETHEL COLONY! WE ARE NOT A DETOX FACILITY.

Have you ever been in addiction treatment, rehab or detox?

Legal Information

YOU MUST TAKE CARE OF ANY OUTSTANDING WARRANTS BEFORE COMING TO BETHEL COLONY.
YOU MUST NOTIFY YOUR PROBATION/PAROLE OFFICER OF YOUR COMING TO BETHEL BEFORE YOU ARRIVE.
Medical Information

(We DO NOT ALLOW Narcotics, Tramadol, Benzodiazepines, Seraquel, gabapentin, Gralise, Neurontin, Horizant, Fanatrex, Trazadone or Ranitidine)

YOU ARE ALLOWED TO SMOKE AT BETHEL BUT NO FORM OF SMOKLESS TOBACCO IS ALLOWED!!

We are offering to help you overcome your bondage; however, this must be on our terms.