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Siam Rehab Admissions Form

Medical care is provided by Dr. Mark Sukkhosawat, a licensed psychiatrist and general practitioner M.D. specializing in substance addiction treatment, with 19 years of experience.

Siam Rehab Admissions Form

This Admissions Form is the second step in the Siam admissions process

  1. Review the admissions requirements (below)
  2. Submit the Siam Rehab Admissions Form (this page)
  3. Discuss the admissions request with Siam’s Admissions Manager
  4. Upon approval, set arrival date and addiction treatment length
  5. Make deposit or full payment
  6. Make flight reservations to Siam Rehab in Chiang Rai
  7. Travel to Siam Rehab to begin the treatment programme

Rehab Admissions Form

Contact Information
Substance Use
Health Background
Previous Addiction Treatment
Arrival and Logistics