2026 Transition Application PART A - Information Questionnaire To be completed by the applicant with assistance, as needed.
Do you have a fixed address?
Please note A New Tomorrow will contact you via telephone and e-mail. Screening Assessments will be conducted virtually wherever possible.
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Next Steps - Recovery Plan
Please provide details of confirmed treatment or second stage recovery placement (can be to attend A New Tomorrow) including relevant contact information for circle of care, and admission date.
Do you self-identify as Indigenous?
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Do you have any outstanding charges?
Are you currently on bail?
Do you give consent to talk to bail supervisor?
Are you currently on probation?
Do you give consent to talk to probation officer?
Are you currently on parole?
Do you give consent to talk to parole officer?
Do you have any upcoming court dates?
Have you ever been convicted of a violent offence?
Have you ever been convicted of a sexual offence?
Do you have a history of engaging in sexually inappropriate, abusive, or non-consensual behaviour?
Do you have a history of fire starting behaviour?
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Mental and Physical Wellbeing
Have you ever received a formal Psychiatric Diagnosis for:
If 'other' or if 'Personality Disorder', please describe:
Are you certified under the Mental Health Act?
Do you have an Acquired Brain Injury (ABI) or a Traumatic Brain Injury (TBI)?
Do you have Fetal Alcohol Syndrome (FASD)?
Do you have any self-injury behaviours? (i.e. cutting, burning, purging, bingeing)
Do you have any suicidal thoughts?
Have you ever attempted suicide?
Do you have any suspected or diagnosed physical concerns? (e.g. seizures, kidney / liver issues) If yes, please describe.
Are you on Opioid Agonist Therapy (OAT)
Have you been admitted to hospital for any reason in the last 3 months?
Do you have any allergies/dietary needs?
Do you have any barriers to completing activities of daily living (ADLs) health concerns that may impact your ability to participate fully in programming? Let us know if you require specific accommodation.
Specific Accommodations Required
Do you have any mobility issues?
If Yes, please describe mobility issues and if you require any mobility aids.
Do you have any scheduled upcoming medical appointments?
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PART B - Substance Use and Treatment History Questionnaire Please provide as much detail regarding your substance use history below
Have you ever been in a treatment program (including day programs) to get help with substance use?
(e.g. heroin, fentanyl, oxycodone, codeine, morphine, hydromorphone) Please provide as much detail regarding your substance use history below.
Treatment Goal (stop use, reduce harm etc.)
Please provide as much detail regarding your substance use history below
Treatment Goal (stop use, reduce harm etc.)
Please provide as much detail regarding your nicotine use history below
Treatment Goal (stop use, reduce harm etc.)
Please provide as much detail regarding your Cannabis use history below
Treatment Goal (stop use, reduce harm etc.)
(e.g. cocaine, amphetamines, methamphetamine, bath salts) Please provide as much detail regarding your substance use history below.
Treatment Goal (stop use, reduce harm etc.)
(e.g. valium (alprazolam), Xanax (diazepam), Ativan (lorazepam)) Please provide as much detail regarding your substance use history below.
Treatment Goal (stop use, reduce harm etc.)
(e.g. mushrooms, ketamine, PCP, LSD, MDMA, solvents, etc.) Anything that doesn't fit the above categories. Please provide as much detail regarding your substance use history below.
Treatment Goal (stop use, reduce harm etc.)
What are your 3 treatment goals?
Circle of Care Please indicate additional people within your circle of care that you would like to be included in planning and supporting your care.
Parole Officer, Probation Officer, Bail Supervisor
Other (psychiatrist, psychologist, mentor etc.)
Release of Information I authorize A New Tomorrow Treatment Solutions to obtain and/or release oral and/or written information pertinent to my stay and programming at the A New Tomorrow facility.
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Funding Information A New Tomorrow Treatment Solutions Ltd. charges a per diem rate of $70.00 per day for a total cost of $2,940.00 for 42 days (6 weeks) of in-patient treatment.
Please indicate who is responsible for payment:
Please select how you will be providing funding
Self-pay / Family Support. Cash, debit, credit, and e-transfer accepted E-transfer: invoice-pmt@ournewtomorrow.ca Password: Kamloops Payment is due 7 business days prior to the scheduled admission date
CPP (Canada Pension Plan) A monthly taxable benefit that replaces part of your income after retirement, typically starting around age 65
CPPD (Canada Pension Plan Disability) A monthly benefit for individuals aged 18 to 65 who are unable to work due to a disability
Ministry (PWD / Income Assistance) PWD (Persons with Disabilities): Provides income and health assistance for individuals 18 and older with severe, long-term impairments that significantly impact daily living Income Assistance (IA): Basic financial support for individuals with limited or no income You must already be approved for and actively receiving PWD or IA for the Ministry to cover treatment
Health Authority – Mental Health & Substance Use (MHSU) You must be actively working with an MHSU clinician, who would complete a bed-based treatment accommodation fee subsidy on your behalf
FNHA (First Nations Health Authority) Funding may be available through a referral from a support worker or clinician The referring provider must complete the referral directly with FNHA
Other (e.g. Band, employer, sponsor, ICBC, third party, etc.)
Clients who self-pay & are admitted to ANT are not eligible for a refund of their per diem costs regardless of when or why they leave the program (i.e. if they self-discharge voluntarily or if they are subject to an involuntary discharge), unless otherwise determined on a case by case basis.
If the per diem is being paid by a 3rd party:
Participation Agreement I understand that A New Tomorrow is an abstinence-based program and there are expectations regarding my conduct while a participant in the program. I agree to the following:
Please agree to the following
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