Concerned Person’s Form

This form is for family, friends and others with a loved one in treatment or continuing care at Aurora Recovery Centre. For all other inquiries, click here for our contact page.

Below is a concerned person’s form for significant others to complete in an effort to provide space to share how your loved one’s addiction has impacted you.

We use the information to address how your loved one’s addiction manifests in their life, and helps us design a recovery management plan for them moving forward.

When completing this concerned person’s form, strong emotions can surface. We encourage you to share this form with a small group of trusted peers. You will receive a copy of this email.

If you prefer this information to be kept confidential, please let us know.

    What is their awareness of the problem?