OBJECTIVES OF THE ASSESSMENT

Submitting your responses through this form indicates the interest of the Government Health care Facility that your represent, . The primary objective of this activity is to collect basic information about your institute and department, upon which we shall further correspond with you for a detailed assessment for feasibility of opening a Facilities in your institution.

WHO CAN PARTICIPATE IN THE SCHEME?

Any Health care facility working directly with the support of any of the Government (Central/State/Local) can express an interest in participating in the scheme. The health care facility may or may not have any existing services for addiction treatment. All participating health care facilities must be willing to provide the basic support (as outlined in the scheme) to ensure the smooth functioning of the scheme.

WHO CAN SUBMIT THIS FORM?

Any responsible individual representing the health-care facility as an in-charge can submit this form (for instance, a Head of the Department / Consultant In-charge / Medical Superintendent). Before responding to this assessment kindly ensure that (a) you have the in-principle concurrence of the administration of the Health care facility and (b) you have identified a "Nodal Officer" ( such as a Consultant Psychiatrist / Senior medical officer / Head of the Department) of the department / hospital who would be responsible for managing the Scheme at your health care facility.

I understand, and I am willing to express the interest of my health care facility in joining this scheme.

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