With expert help the cycle
of addiction can be broken.

 

Below is concerned person's form for significant others of patients in our care to complete. This is an opportunity for you to share your perspective on the patient as well as the impact addiction has had on you. We encourage you to share openly so the concerned person's form can be used as a therapeutic tool.

 

Concerned Person’s Form

This form is for family, friends and others with a loved one in treatment at Aurora Recovery Centre. For all other communication, please visit our contact page.

Below is a concerned person’s form for significant others of patients in our care to complete. This is an opportunity for you to share your perspectives on the patient as well as the impact their addiction has had on you. We encourage you to share openly so the concerned person’s form can be used as a therapeutic tool.

We use the information you provide to bring clarity to the patient, to begin healing relationships and to help us design a recovery management plan that includes the larger perspective of the patient’s life.

We encourage you to connect with New Dawn, therapeutic program for families, for support. We also provide Family Support Group at Aurora every Sunday from 10:30am-12:00p (CDT).

This FREE weekly group provides support and education about addiction recovery.

Facilitated by our family program director Donna Low ~ CCAC, Certified Satir Family Systems Transformational Therapy, this group builds connections that fracture the isolation commonly experienced in families living with active substance use disorder.

Donna has designed and facilitated several of Canada’s premier family programs and her ability to bring genuine compassion and expertise to her work creates the perfect environment for healing.

Please join us online via Zoom on Sundays from 10:30am-12:00pm (CDT):

We look forward to your participation: Contact Donna Low for Link at 204 407 7644

    Contact Information

    Addiction Profile

    What is their awareness of the problem?
    No awareness: I don't have a problem. It's not worse than anybody else's.Minimal awareness: Sure, I've had a problem, but I can take it or leave it.Moderate awareness: I have a problem, but I can handle it on my own.Admits to a problem and accepts responsibility for change.

    Relationship with Others

    Negative Behaviors

    Your Observations

    I would like to keep this information confidential.I would like to share this information with my loved one.