Questions to Ask Before Choosing a Rehab Facility
Choosing a rehab facility is one of the most consequential healthcare decisions a person or family can make, and most people make it with very little information. Treatment programs vary enormously in clinical approach, staffing, accreditation status, and aftercare support. The difference between a well-run program and one that is poorly managed can affect not only the immediate treatment experience but long-term recovery outcomes. This guide provides the specific questions that matter most when evaluating a facility, organized by category so families can approach the process systematically rather than relying on a facility’s marketing materials alone.
Key Takeaways
- Always verify a facility’s state licensing through NJ DMHAS and check for CARF or Joint Commission accreditation independently
- Ask about staff-to-patient ratios, clinician credentials (LCADC, LPC, LCSW), and whether a physician or psychiatrist is on site
- Programs should use evidence-based therapies such as CBT, DBT, or EMDR and offer medication-assisted treatment when clinically appropriate
- Request a written aftercare plan before admission, not just a verbal promise of follow-up
- Legitimate facilities will answer these questions openly; evasiveness is a red flag
Why the Right Questions Matter
Most people searching for addiction treatment are doing so during a crisis. A loved one has overdosed, a job has been lost, or a relationship has reached a breaking point. Under that kind of pressure, families tend to choose the first program that answers the phone, the one with the most polished website, or the one recommended by someone they trust without verifying whether the recommendation is based on actual treatment quality.
This is understandable but risky. The addiction treatment industry in the United States includes thousands of licensed facilities alongside programs that operate with minimal oversight. In New Jersey, the Division of Mental Health and Addiction Services (DMHAS) licenses treatment providers, but licensing alone does not guarantee clinical quality. A license means a program has met the minimum requirements to operate. It does not mean the program is well-staffed, evidence-based, or effective.
What Families Often Overlook
Families frequently focus on surface-level factors: the appearance of the facility, the friendliness of the admissions staff, and whether the program accepts their insurance. These things matter, but they are not reliable indicators of treatment quality. A facility with a beautiful campus and a responsive admissions team may still lack board-certified addiction medicine physicians, rely on outdated treatment models, or have no structured aftercare planning.
The questions that actually predict outcomes relate to clinical practices, staff qualifications, individualized treatment planning, and what happens when the residential phase ends.
How Facilities Should Respond
A reputable treatment center will welcome detailed questions. Clinical leadership at CARF-accredited or Joint Commission-accredited programs expects inquiries about their approach, credentials, and outcomes. If an admissions representative cannot answer clinical questions or becomes evasive when asked about accreditation status, that is meaningful information.
Facilities should be able to provide their license number, accreditation status, a general overview of their treatment model, and a clear explanation of costs beyond what insurance covers. If a program cannot or will not share this information before admission, consider it a warning sign.
Questions About Licensing, Accreditation, and Staff
State Licensing and Joint Commission Status
The first set of questions establishes whether a facility meets baseline regulatory standards:
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Is the facility licensed by the NJ Division of Mental Health and Addiction Services (DMHAS)? Every legitimate treatment facility in New Jersey must hold current DMHAS licensure. Ask for the license number and verify it independently through the state.
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Is the program accredited by CARF or the Joint Commission (JCAHO)? Accreditation by the Commission on Accreditation of Rehabilitation Facilities (CARF) or the Joint Commission goes beyond state licensing. These bodies conduct on-site reviews of clinical practices, safety protocols, and patient rights. Accreditation is voluntary, and programs that pursue it are generally held to higher operational standards.
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Are there any recent citations, violations, or corrective action plans? State licensing agencies and accreditation bodies issue findings when programs fall short. A facility that has recently addressed a corrective action plan is not necessarily bad, but transparency about it matters.
Staff-to-Patient Ratios and Credentials
The people delivering treatment matter more than the building they work in:
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What is the clinical staff-to-patient ratio? There is no universal standard, but lower ratios generally mean more individualized attention. Ask specifically about the number of licensed clinicians relative to the census, not just total staff including administrative and support roles.
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What credentials do your counselors and therapists hold? In New Jersey, look for Licensed Clinical Alcohol and Drug Counselors (LCADC), Licensed Professional Counselors (LPC), and Licensed Clinical Social Workers (LCSW). Programs staffed primarily by peer support specialists or uncredentialed counselors may lack the clinical depth needed for complex cases.
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Is a board-certified physician or psychiatrist on staff or available on-site? This is especially important for programs treating co-occurring mental health disorders or providing medication-assisted treatment. A psychiatrist’s involvement in treatment planning improves outcomes for patients with dual diagnoses.
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What is the staff turnover rate? High turnover disrupts therapeutic relationships and can indicate systemic problems within the organization. Most facilities will not advertise this, but asking signals that you are evaluating the program seriously.
Questions About Treatment Approach and Programming
Evidence-Based Therapies Offered
Treatment programs should be able to articulate their clinical model clearly:
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What therapeutic modalities do you use? Look for evidence-based practices. Cognitive-behavioral therapy (CBT) has the strongest research base for substance use disorders. Dialectical behavior therapy (DBT) is effective for patients with emotional dysregulation or borderline personality traits. Eye movement desensitization and reprocessing (EMDR) is used for trauma-related substance use. Ask which of these are standard parts of programming versus available by special request.
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How do you address co-occurring mental health conditions? According to SAMHSA, roughly half of individuals with a substance use disorder also have a co-occurring mental health condition. Programs that treat addiction in isolation, without addressing depression, anxiety, PTSD, or bipolar disorder, may produce poorer outcomes. Integrated dual-diagnosis treatment is the current clinical standard recommended by both SAMHSA and ASAM.
Individualized Treatment Planning
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How are treatment plans developed? The answer should involve a comprehensive assessment using ASAM criteria, which evaluates six dimensions including intoxication and withdrawal potential, biomedical conditions, emotional and behavioral conditions, readiness to change, relapse potential, and recovery environment. A one-size-fits-all program that puts every patient through the same curriculum regardless of their clinical profile is not following current best practices.
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How often are treatment plans reviewed and updated? Plans should be revisited regularly, typically weekly or biweekly, based on the patient’s progress. Static plans that never change suggest the program is not responsive to individual needs.
Medication-Assisted Treatment Availability
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Do you offer medication-assisted treatment (MAT)? For opioid use disorders, medications such as buprenorphine (Suboxone) and naltrexone (Vivitrol) are considered standard of care by ASAM, SAMHSA, and the National Institute on Drug Abuse (NIDA). Programs that refuse to offer MAT as a matter of philosophy, rather than clinical judgment, are operating outside current evidence-based guidelines.
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Can patients continue MAT that was prescribed before admission? Some programs require patients to discontinue medications upon entry. This practice is not supported by current medical evidence and can be dangerous, particularly for patients stabilized on buprenorphine or methadone.
Questions About Cost, Insurance, and Payment
Insurance Verification Process
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What insurance plans do you accept, and will you verify benefits before admission? A responsible facility conducts a thorough insurance verification before a patient arrives. This means contacting the insurer to confirm coverage for the specific level of care, determining the patient’s deductible and copay obligations, and identifying any pre-authorization requirements. Under the Mental Health Parity and Addiction Equity Act, most group insurance plans must cover addiction treatment at parity with medical and surgical care.
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What happens if insurance denies coverage or authorizes fewer days than planned? This is common. Insurers frequently authorize a shorter stay than what the clinical team recommends. Ask how the facility handles utilization review disputes and whether they have staff dedicated to advocating with insurers on behalf of patients.
Out-of-Pocket Costs and Sliding Scale
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What are the total out-of-pocket costs beyond insurance coverage? Ask for a detailed breakdown. Some programs charge separately for items that patients might assume are included: psychological testing, family sessions, specialized groups, or medications.
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Do you offer sliding-scale fees or financial assistance? In New Jersey, DMHAS funds a network of state-funded treatment programs for uninsured or underinsured residents. If cost is a barrier, ask whether the facility participates in state-funded programming or can connect you with a program that does.
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Is there a refund policy if the patient leaves before completing the program? Particularly relevant for programs that require payment upfront, this question protects families from losing thousands of dollars if treatment needs to be adjusted or the patient requires a different level of care.
Questions About Aftercare and Discharge Planning
Transition to Outpatient or Sober Living
Discharge planning is one of the strongest predictors of sustained recovery, yet it is often the most neglected part of treatment:
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When does discharge planning begin? Best practice is to start aftercare planning at admission, not in the final days of the program. Ask whether the facility assigns a discharge coordinator and how early they begin identifying outpatient resources.
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Do you help arrange step-down care such as a partial hospitalization program (PHP), intensive outpatient program (IOP), or standard outpatient therapy? The transition from 24-hour residential care to independent living is the highest-risk period for relapse. Programs that discharge patients without a concrete step-down plan are leaving a critical gap.
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Do you have relationships with sober living facilities? Many patients benefit from a structured living environment after completing residential treatment. Ask whether the facility has vetted sober living partners and whether they assist with placement.
Relapse Prevention Support
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What relapse prevention tools are built into the program? This might include developing a written relapse prevention plan, practicing coping strategies in real-world scenarios, or connecting with mutual aid groups like Narcotics Anonymous or SMART Recovery during treatment.
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Is there any alumni program or ongoing support after discharge? Some facilities offer alumni groups, check-in calls, or access to recovery support services after treatment ends. These touchpoints can help bridge the gap between structured treatment and independent recovery.
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Do you connect patients with recovery coaching or peer support services? Recovery coaches and certified peer recovery specialists provide ongoing, non-clinical support that complements therapy and mutual aid. In New Jersey, several organizations provide these services, and a facility with established referral pathways demonstrates a commitment to long-term outcomes.
The Master Question Table
The questions covered in the sections above are organized by topic — licensing, treatment approach, cost, aftercare. The table below consolidates them into a single scannable reference, with the reasoning behind each question and what a strong answer looks like. Use this in an admissions call as a checklist: read the question aloud, listen to the answer, compare against the strong-answer column, move to the next one.
Licensing, accreditation, regulatory standing
| Question | Why it matters | Strong answer |
|---|---|---|
| What is your NJ DMHAS license number, and can I verify it? | Every NJ SUD treatment facility must be DMHAS-licensed. License number is public info. | Specific number provided; facility listed on NJ DHS provider directory. |
| Are you CARF or Joint Commission accredited? When is your next survey? | Voluntary accreditation beyond licensing signals commitment to quality. | Named body + current accreditation + known next survey date. |
| Have you had recent citations, violations, or corrective action plans? | Transparency signal; a program that has been cited and addressed it is fine, one that hides it is not. | Direct disclosure if applicable; “no current active findings” if not. |
| Are you LegitScript certified (for facilities that market through Google Ads)? | LegitScript is required for Google Ads placement; a useful trust signal. | Certification number provided and verifiable on LegitScript registry. |
Clinical staffing
| Question | Why it matters | Strong answer |
|---|---|---|
| What is the clinical-staff-to-patient ratio? | Higher ratios mean more individualized attention. | Specific ratio (e.g., 1:4 clinical, 1:8 overall); not “we have a great team.” |
| What are the credentials of counselors and therapists? | LCADC, LPC, LCSW in NJ are the primary clinical credentials. | Named credentials; percentage of staff with each; not “our counselors are trained.” |
| Is a board-certified addiction medicine physician on staff? | Addiction medicine certification (ABPM) is a meaningful clinical marker. | Yes, named physician, with board certification confirmed. |
| Is a psychiatrist or psychiatric NP on staff, and how often are they on-site? | Critical for dual diagnosis care; occasional consultation is not the same as integrated psychiatry. | Specific hours per week or days on-site, not “on-call.” |
| What is your staff turnover rate? | High turnover disrupts therapeutic continuity. | Specific rate or comparison to industry norm; acknowledgment if high and what they’re doing about it. |
| Who is the clinical director, and what are their credentials? | Leadership quality shapes program quality. | Named individual with addiction medicine or behavioral health senior credentials. |
Clinical approach and treatment planning
| Question | Why it matters | Strong answer |
|---|---|---|
| What specific therapeutic modalities do you use? | Evidence-based therapies are not a menu to check — they require specific training. | Named modalities (CBT, DBT, EMDR, Seeking Safety, MI, CPT); specific therapists trained in each. |
| Do you use ASAM criteria for level-of-care determination? | ASAM is the clinical standard. | Yes, with described assessment process. |
| How is a patient’s individual treatment plan developed? | Plans should be specific to each patient, not templated. | Comprehensive assessment; patient participation; regular review cadence. |
| How often are treatment plans reviewed and adjusted? | Static plans suggest non-responsive programming. | Weekly or biweekly documented review. |
| Do you offer contingency management for stimulant use disorder? | CM is the strongest evidence-based stimulant intervention. | Yes, with specific incentive structure. |
| Do you treat co-occurring conditions in an integrated model? | Parallel treatment is inferior to integrated treatment. | Yes, with integrated team, single treatment plan, coordinated medication management. |
| What trauma-informed framework do you operationalize? | ”Trauma-informed” as marketing is different from specific modalities. | Named framework (Seeking Safety, TREM, TF-CBT); organizational implementation detail. |
Medication-assisted treatment
| Question | Why it matters | Strong answer |
|---|---|---|
| Do you offer all three FDA-approved MAT medications for OUD (buprenorphine, methadone, naltrexone)? | Programs that offer only one are limiting clinical options. | Yes to all three, or referral pathway for the ones not offered directly. |
| Can patients continue MAT that was prescribed before admission? | Forced discontinuation is not evidence-based and can be dangerous. | Yes, MAT is continued through admission. |
| Do you use low-dose (Bernese) buprenorphine induction for fentanyl-era patients? | Traditional induction protocols don’t work well with fentanyl. | Yes, familiar with the protocol. |
| Do you use Vivitrol, and what is your protocol for opioid clearance before administration? | Vivitrol requires full opioid clearance or precipitated withdrawal occurs. | Specific timeline-based protocol (typically 7-14 days with verification). |
| Do you offer MAT for alcohol use disorder (naltrexone, acamprosate, disulfiram)? | AUD MAT is under-used; programs should offer it. | Yes, with clinical judgment about which medication. |
| How is psychiatric medication managed during the treatment episode? | Reactive medication management is inferior to proactive optimization. | Regular psychiatric visits, active titration, documented med-management plan. |
Insurance, cost, administrative
| Question | Why it matters | Strong answer |
|---|---|---|
| What insurance plans are you in-network with? | Out-of-network changes cost dramatically. | Specific carrier list; verified for my plan. |
| Do you accept NJ FamilyCare, and through which MCOs? | Medicaid MCO network matters. | Yes, with specific MCO list (5 MCOs: Aetna Better Health, Fidelis Care NJ, Horizon NJ Health, UHC Community Plan, Wellpoint). |
| Will you verify my benefits before admission, and what is the turnaround? | Verification prevents surprises. | Yes, 24-72 hour turnaround, written benefits summary provided. |
| What is my estimated out-of-pocket cost before I arrive? | Vague “we’ll figure it out” is a red flag. | Specific dollar estimate based on plan details. |
| What is your protocol when insurance denies or authorizes less time than clinically recommended? | Denials and shortenings are common. | Detailed appeals process, dedicated utilization-review advocate. |
| Do you pursue single-case agreements for out-of-network patients? | SCAs allow in-network rate at OON facility for network adequacy. | Yes, with defined SCA process. |
| Is there a refund policy for early departure? | Upfront-payment programs without refund policies are high risk. | Written refund terms, pro-rated for unused days. |
| Do you offer sliding-scale or scholarship funding? | Nonprofit and state-funded programs often do. | Yes, with eligibility criteria; or direct referral to programs that do. |
Aftercare and continuity of care
| Question | Why it matters | Strong answer |
|---|---|---|
| When does discharge planning begin? | Best practice is admission, not last-week-of-program. | Day 1 or first week; named discharge coordinator. |
| Do you arrange a specific step-down (PHP, IOP, outpatient) before discharge? | Generic referrals don’t work; specific placements do. | Yes, with specific provider and first-appointment date. |
| Do you coordinate MAT continuity with an outpatient prescriber? | MAT gaps post-discharge are high relapse risk. | Yes, with handoff prescription bridging the gap. |
| Do you help arrange sober living when clinically indicated? | Housing instability predicts relapse. | Yes, with vetted partner residences. |
| Do you have an alumni program? | Alumni engagement predicts sustained recovery. | Yes, with described programming frequency. |
| Do you connect patients with NJ peer recovery specialists? | NJ PRSS is a strong aftercare resource. | Yes, with specific NJ PRSS contact or program relationship. |
| What is your crisis protocol for a post-discharge recurrence of use? | Recurrence plans prevent abandonment. | Specific re-engagement pathway; not “call 911.” |
Transparency, outcomes, and accountability
| Question | Why it matters | Strong answer |
|---|---|---|
| Do you measure treatment outcomes? | Without measurement, no accountability. | Yes, with specific instruments (AUDIT, DAST, PHQ-9, GAD-7, PCL-5) at defined intervals. |
| What is your treatment completion rate, and how do you define completion? | Completion rates vary widely and definitions differ. | Specific number with defined “completion” (e.g., full planned LOS + aftercare engagement). |
| What is your 6- or 12-month abstinence rate among responsive alumni? | Real follow-up data is the gold standard. | Specific number with defined follow-up methodology and response rate. |
| What is your re-admission rate? | Re-admission is not automatically bad but informative. | Specific number with commentary on what it means in your program’s context. |
| Do you have a complaints process, and how are grievances handled? | Every program has complaints; handling matters. | Specific process, not “we take complaints seriously.” |
A program that can answer most of this table specifically and without deflection is operating at the level supported by current evidence-based practice. A program that cannot answer significant portions, or whose answers are vague, is not necessarily bad but requires more scrutiny before admission.
What Evasive Answers Sound Like (And What They Translate To)
Not every vague answer is a red flag. Admissions teams field hundreds of calls and some questions don’t have simple answers. But specific patterns of deflection consistently correlate with programs that have something to hide or something they can’t deliver. Below are the most common ones, what they actually mean, and how to follow up.
Evasive answer: “Our staff is highly qualified — we have a great team with decades of combined experience.”
What it translates to: The specific credentials of the staff aren’t strong, or the program doesn’t want to disclose the ratio of credentialed clinicians to support staff.
Follow-up: “Can you tell me specifically: how many LCADCs, LPCs, and LCSWs are on staff, and what is the ratio of licensed clinicians to patients?”
Evasive answer: “We offer a comprehensive, personalized treatment plan tailored to each patient.”
What it translates to: The clinical model is either a template everyone goes through or isn’t formalized enough to describe specifically.
Follow-up: “Can you walk me through the specific assessment process, who develops the plan, and how often it is reviewed with the patient?”
Evasive answer: “We use evidence-based practices including CBT and DBT.”
What it translates to: CBT and DBT are mentioned but may not be delivered at fidelity. “Evidence-based” without specific modality names and trained therapists can mean workbook-based group work rather than manualized therapy.
Follow-up: “Which specific therapists are trained in full-fidelity DBT, and does the program include individual DBT + skills group + phone coaching + consultation team, which are the four required components?”
Evasive answer: “Yes, we have a psychiatrist available.”
What it translates to: Possibly a consulting psychiatrist who comes in once a week or sees patients via telehealth only; not part of the integrated clinical team.
Follow-up: “How many hours per week is the psychiatrist physically on-site, and do they participate in clinical team rounds?”
Evasive answer: “We work with most major insurance plans and will verify your benefits.”
What it translates to: They may be out-of-network with your specific plan but willing to submit claims at OON rates, which can leave you with significant out-of-pocket cost.
Follow-up: “Are you in-network with my specific plan (name it)? If not, will you pursue a single-case agreement, and what is my out-of-pocket cost at OON rates?”
Evasive answer: “Our success rates are very high — many of our patients stay sober long-term.”
What it translates to: No formal outcome measurement. The statement is based on impressions, not data.
Follow-up: “What instruments do you use to measure outcomes, at what intervals, and what was your most recent measured 12-month abstinence rate?”
Evasive answer: “We offer a full continuum of aftercare including alumni support, outpatient services, and connections to sober living.”
What it translates to: Aftercare exists in theory but may not be operationally integrated. Alumni support can mean an occasional email; outpatient connections can mean handing the patient a list of phone numbers.
Follow-up: “Before discharge, will you have scheduled a specific first outpatient appointment with a named provider, arranged sober living if indicated, and bridged any MAT prescriptions?”
Evasive answer: “We’ll handle the insurance details — don’t worry about the cost.”
What it translates to: The facility may not disclose out-of-pocket responsibility upfront. Patients sometimes receive bills months after discharge for amounts they didn’t expect.
Follow-up: “Can I get a written estimate of my out-of-pocket responsibility before I admit, and will you confirm in writing what my deductible and coinsurance obligations will be?”
Evasive answer: “That’s a question for our admissions team — they’ll explain everything when you call.”
What it translates to: The person you’re currently speaking with is admissions or sales, and they are redirecting clinical questions to another staff member who may or may not be clinically qualified.
Follow-up: “Can you connect me directly with the clinical director or a licensed clinician who can answer clinical questions, since that’s what this is about?”
The meta-signal. A program that responds to most of your questions with specific, confident answers — and acknowledges limits when asked about things they don’t do — is usually operating from a position of clinical strength. A program that responds with consistent marketing language, redirection, and vague reassurance is usually operating from a position of marketing strength that isn’t backed by clinical depth. The difference is audible in the first 10 minutes of a call if you know what to listen for.
Red Flags That Should Give You Pause
Beyond what facilities tell you, pay attention to what they do not say or how they respond. The following patterns warrant caution:
- Guaranteed outcomes. No legitimate program guarantees sobriety. Recovery is a long-term process influenced by many factors beyond any single treatment episode.
- Pressure to admit immediately without a clinical assessment. Responsible programs conduct a thorough evaluation before confirming that their level of care is appropriate.
- Inability to explain their clinical approach in specific terms. Vague language like “holistic healing” or “whole-person care” without concrete details about therapies, staffing, and structure can mask a lack of clinical rigor.
- Resistance to sharing accreditation or licensing information. This is public information and should be readily available.
- No aftercare planning. A program that ends at discharge is only doing part of the job.
Choosing a rehab facility is not a decision that should be rushed, even when the situation feels urgent. The questions in this guide provide a framework for evaluating programs on the factors that actually matter. Families who approach this process with clear criteria and specific questions are better positioned to identify programs that offer genuine clinical value.
This article is part of our complete guide to choosing a rehab center. For help assessing whether treatment is needed, see Should I Go to Rehab?. If you are trying to help a reluctant loved one, read How to Get Someone into Rehab. You may also find our overview of treatment types and guide to insurance and cost helpful as you evaluate your options.
Looking for treatment options in your area? We can help point you in the right direction. (888) 699-0742 — or request a callback.