Admissions Forms

1. Screening Form

If you are interested in becoming a resident, please choose one of the following options as a first step:

1. Call our office (336-342-9504) to go over a screening form verbally.

2. Download a screening form at the top of this page, complete it, and send it to us via fax (336-342-9506) or email (info@remmsco.org).  

2. Phone Interview

Schedule and complete a phone interview with the Director of REMMSCO, Inc. through the main office telephone number at (336) 342-9504.

3. Physician's Statement

Have a physician complete and sign the physician's statement (available for download above) certifying your ability to participate in the REMMSCO program. 

The physician's statement must include details of medication requirements. These medications must be cleared with the Director of REMMSCO, Inc. The REMMSCO program does not accept residents who are on maintenance drugs such as suboxone or methodone. 

Fax the completed and signed physician's statement to the REMMSCO, Inc. main office at (336) 342-9506, or email it to info@remmsco.org

4. Intake

The Director will contact you and tell you whether you have been cleared for admission and set the date and time for the admissions intake.

The completed screening form, physician's statement, and Tuberculosis test results if available should be faxed to the REMMSCO, Inc. main office at (336) 342-9506 or emailed to info@remmsco.org. The screening form and physician's statement forms are available for download at the top of this page.

The phone interview should be scheduled and conducted through the REMMSCO, Inc. main office number at (336) 342-9504.

1. Physician's statement and tuberculosis test results (if these have not previously been provided.)

2. Identification

• Photo ID (state ID, driver's license, passport etc.)
• Social security card (if available)
• Medicaid and/or Medicare card

3. Medications

• A 30-day supply of medications matching those listed on the physician's statement as ordered by a physician and cleared by the Director.
• Any over-the-counter medications not listed in the physician's statement will be confiscated.
• All approved medications will be secured and administered in the staff office by the staff on duty.

4. Money

• The admissions fee of $50 in the form of cash or money order.
• Personal spending money. Do not, however, bring large sums of money, jewelry, or other valuables, as REMMSCO, Inc. will not be responsible for articles lost, stolen, or damaged during the time of residency.

5. Clothing

• At least 5 days' worth casual clothing.
• Conservative night wear. A robe and slippers are encouraged.
• Shoes and work clothes appropriate for gardening and yard work.
• Dress clothes for formal events such as church services, if desired.
• Do not bring tanktops, body shirts, sleeveless shirts, crop tops, low-cut tops, skirts or shorts that are not at least fingertip length, or clothing with inappropriate words or symbols.
• Leggings are not acceptable unless a skirt or pants going to at least fingertip length is being worn over them.

6. Toiletries and Bedding

• Bring personal items and toiletries such as deodorant, shampoo, or shaving tools. Anything with alcohol content such as mouthwash will be confiscated. Anything that could be used as a weapon, such as pocket knives or straight razors will also be confiscated.
• Do not bring bedding or towels. These will be provided.
• You may bring your own pillow and washcloths, but these will be provided.

7. Furniture and Appliances

• Do not bring furniture or appliances such as microwaves and blenders.
• You may bring small CD players, radios, clocks, or other small items such as pictures for your room.

8. Electronics

• You may bring your cell phone, laptop, and other small electronics.
• Use of cell phones and other electronic communication devices will be restricted for the first seven days of residence. Some limitations and restrictions will apply after this period in the interest of conscientiousness and client confidentiality, e.g. during recovery meetings.

9. Vehicles

• Automobiles are permitted on an individual basis, as transportation will be provided by one of our staff members, who are available 24 hours a day.

10. Pets

• No pets or other animals are permitted.

Do not bring large sums of money, jewelry, or other valuables. REMMSCO, Inc. will not be responsible for articles lost, stolen, or damaged during the time of residency.