Main Office: 112 S. State St. Concord, NH 03301 also in Manchester, Franklin and Northwood

intake@crc-idcmp.com

Chrysalis Recovery Center, LLC & CRC's DWI Program (IDCMP)

All Locations Call: 603-998-4210

If you need to have an Intake at an IDCMP for a recent DWI Conviction - Please Complete this form and we will call you within one business day to schedule your intake.

Thank you for contacting us. We will get back to you as soon as possible. To contact our Intake Coordinator by phone please call Kyle MacArthur at 603-998-4210

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Want to Sign Up For a Class At Chrysalis?? Complete this and we will respond to you within 24 hours.

Thank you for contacting us. We will get back to you within 24 hours. Thank you for choosing Chrysalis.

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Mailing Address for Chrysalis: 112 S. State Street Concord, NH 03301 (HOURS in CONCORD; Mon-Fri 8-5 - Sat/Sun by appt only)

Main Location is our Concord Address: 112 S. State St. Concord, NH 03301

Satellite Offices:

Manchester Location: 15 High St. Manchester, NH 03101

Franklin Location: 20 Canal St. Franklin NH 03235 - In the Franklin Business Center - up one floor

Northwood Location: 1130 1st NH Turnpike Northwood, NH 03264 - (aka Route 4)

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Name
Address
Phone Number
Email Address
Date of DWI Conviction
Type of DWI Conviction	Aggravated Not Aggravated DWI First Offense DWI II DWI - 3+
BAC (or write refused)
Where would you like your intake	Franklin Concord Manchester Northwood
Message
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