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

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