All original completed forms should be mailed to:
- Department of Human Services
- Division of Alcoholism & Substance Abuse
- Bureau of Licensing and Certification
- 410 S. Clinton, 2nd Floor
- Chicago, IL 60607-3800
- For additional information about DASA licensing & certification, call (312) 814-3840.
Initial Application for Alcoholism & Other Dependency Treatment / Intervention License or Medicaid Certification
Substance Abuse Service Application Instructions and Guidelines
- Substance Abuse Service Application Cover letter (pdf) - Initial application for Alcoholism and Other Drug Dependency Treatment/Intervention License or Medicaid Certification. BEFORE BEGINNING THE APPLICATION PROCESS, BE SURE TO READ THIS LETTER.
- The following rules govern substance abuse treatment and intervention services licensing (2060) and Medicaid certification (2090). Please read the applicable rule prior to completing the application.
Important Notice for CITY OF CHICAGO providers: A resolution from the Zoning Board of Appeals to obtain a Special Use Permit for a Transitional Shelter is REQUIRED to open a Residential Rehabilitation, Residential Extended Care facilities (Halfway House) and Recovery Homes in the City of Chicago.
Substance Abuse Service Application Forms
Architect Life Safety Report forms
Off-site Exception Request forms and information