National Alcohol Screening Day

Thank you for participating in our program. Please fill out our summary form by first finding your organization in our database:

We need to search our database to find your organization.

Please enter your POSTAL/Zip CODE in the prompt below . If you're unsure of your Postal/Zip Code, select your STATE/Province from the list.
Postal/Zip Code:
OR
State/Province:  
 

 
  If you cannot find your organization in our database, please call our offices @ 781-239-0071.