Guiding You Through Our Application Process

Darrin’s Place in Espanola, NM, is dedicated to providing recovery programs tailored to our client’s individual needs.

Man undergoing an interview with family support

Our Process

We want you to achieve a successful recovery. To determine the level of service needed, an assessment, a medical clearance, and a psychological evaluation may be completed prior to admittance. One of our staff members will assist you throughout the entire intake process. We ensure that we will walk you through every step of the way.

Get Started

We are here to help! If you are interested in any of our programs or services, you may call our intake coordinator at (505) 372-4511 or click on the Request for Services link below. You will never be denied services based on inability to pay. A discounted/sliding fee scale is available based on income and family size. We look forward to hearing from you soon.

Man being distant from his friends

Request For Services

APPLICANT INFORMATION

Your application is completely confidential.  All information is stored in a secure environment and used only for purposes related to your admission and recovery program.

This practice serves all clients regardless of inability to pay. Discounts for essential services are offered based on family size and income. For more information, ask at our Front Desk or reach out to our Admissions Coordinator at 505-376-7288. Thank you.

Darrin’s Place Behavioral Health agrees to not discriminate in the provision of services to any individual based on the individual inability to pay; whether payment for those services would be made under Medicare, Medicaid, or CHIP; the individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity will not be factors in the denial of an applicant. Darrin’s Place Behavioral Health will have a sliding/partial fee scale and application accessible to all applicants and provided through email, fax and, or in person. Darrin’s Place Behavioral Health Admission and Front Desk team will be knowledgeable of the Sliding/Partial fee scale to provide further details for applicants. ” 

 

  • Treatment Length (please check all that apply)

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  • Select all that apply:

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  • EMERGENCY CONTACT

  • MEDICAL INSURANCE

  • CRIMINAL OFFENSE HISTORY

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  • MEDICAL HISTORY

  • MEDICAL HISTORY CONTINUED

  • MENTAL HEALTH HISTORY

  • WAIVER TO RELEASE APPLICATION STATUS

  • Date Format: MM slash DD slash YYYY
  • I hereby authorize Darrin’s Place to release information regarding my application status. This authorization of release includes my application approval, estimated wait time, program acceptance, and intake for the purpose of collaboration and coordination of services.
  • I authorize the following people to obtain my application status:.
  • I Disclosure: I understand that Darrin’s Place cannot guarantee that the recipient will not disclose my application status to a third party.
    I understand that I can revoke my waiver at any time and for any reason. I understand that my Authorization will automatically expire one year from the date of my signature unless I request it be revoked earlier (see below).
  • Date Format: MM slash DD slash YYYY

  • TRANSITION PLANNING

  • Darrin’s Place is an Intensive Outpatient Treatment center providing evidence based and person-centered drug and alcohol rehabilitation treatment. Our evidence-based treatment program promotes a long term sobriety lifestyle which includes transition planning as soon as treatment is initiated. For this reason, Darrin’s Place request that clients identify a safe discharge destination and a person who is supportive of his/her recovery.
  • If no discharge destination has been identified, I authorize Darrin’s Place to provide transportation or make arrangements for transportation to a mutually agreed upon location regardless of the reason for my discharge.

    I understand that I must notify Darrin’s Place if my discharge destination changes.
  • Date Format: MM slash DD slash YYYY

  • ACKNOWLEDGMENT OF APPROVED AND PROHIBITED ITEMS

  • It is Darrin’s Place policy that any prohibited items are not allowed on property at any time without prior written approval from the Executive Director. Prior to admission, a thorough search of your person and property will be conducted. Possession of any of the prohibited items may result in revocation of your application and/or admission status. Possession of any prohibited items after the admission process is completed may result in your immediate discharge from the facility.

    Approved Items Allowed Upon Admission



    • Pants/Jeans (up to 10)
    • Sweat Pants (up to 10)
    • Sweat Shirts (up to 10)
    • Shirts (up to 10)
    • Shoes (up to 3)
    • Underwear (up to 10)
    • Bras (up to 10)
    • Jackets/Light sweater (up to 3)
    • Pajamas (up to 3)
    • Shower Shoes (1) / Slippers (1)
    • Cell Phones (1)
    • Robe (1)
    • Belts (1)
    • Hats (2)
    • Towels (5)
    • Washcloths (5)
    • Undershirts (7)
    • Musical Instruments Ex: Drums (1-2)
    • Art Supplies (alcohol free)
    • Face Masks
    • 30-day supply of all current medication and medical supplies

    Starter Kit



    • Basic Hygiene Items-Shampoo, Conditioner, Soap, Guarded Razors, Shaving Cream, and Feminine hygiene products (alcohol must not be listed in the first 3 ingredients)
    • One carton of cigarettes

    Non-Approved Items



    • Outside Food or Drinks
    • Nail Polish/Nail Polish Remover
    • Hair Dye
    • Hairspray (if alcohol is in the first 3 ingredients listed)
    • Perfume (if alcohol is in the first 3 ingredients listed)
    • Coconut Oil
    • Straight Razors
    • Sharpie Markers
    • Bandanas
    • DVD Players/Portable DVD Players
    • Fire Stick, Roku, Google TV or any media streaming devices
    • Sexually oriented materials and/or products
    • Essential Oils
    • Power Strips/3 way connectors
    • Guns/Ammunition/Knives
    • Pepper Spray
    • Stun gun/Tasers
    • Multi-use tools (Leatherman)
    • Any item fashioned as a weapon


    Darrin’s Place reserves the right to change the list above as necessary for the safety of our staff and clients.
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