All original completed forms should be mailed to:

  • Illinois Department of Human Services
  • Division of Alcoholism and Substance Abuse
  • Licensing and Certification
  • 401 South Clinton Street, Second Floor
  • Chicago, Illinois 60607-3800
  • For additional information about DASA licensing and certification, please call (312) 814-3840.

Initial Application for Substance Use Disorder Intervention/Treatment License or Medicaid Certification

  • Substance Use Disorder Service Application Instructions and Guidelines

  • (BEFORE beginning the application process, be sure to read the following two letters.) 

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.

Architect Life Safety Report Forms

Off-site Exception Request Forms and Information

If you are experiencing problems opening any of the above .pdf documents, you may have an old version of Adobe Reader.

If you continue to experience problems with accessing documents on this page, e-mail the DASA Help Desk at