dawn farm

Community of Programs

DAWN FARM RESIDENTIAL

FEE AGREEMENT
Dawn Farm provides comprehensive residential services. This Fee Agreement covers basic
services for _______________________________, to include:

• Room and board • Daily group and individual therapy

• Basic medical care • Supervised work therapy
• Addiction education • Recreation, exercise and arts and crafts
• Transportation to AA • Family Clinical Services
• Aftercare and follow-up services • Vocational referral (as needed)
• High school/GED • Transitional Housing referral

This Fee Agreement acknowledges a flat per diem fee of $90.00 for the above-noted services.
This fee is generously subsidized by community donations in order to make it more affordable.

A non-refundable $630.00 Admission Fee is included in the first month. If a resident leaves treat-
ment in the first 7 days, the cost is $630.00. After 7 days the bill accrues at the bed/day cost
(e.g., 21 days at $90.00 would cost $1,890.00).

If a resident requires psychiatric services, fees are as follows: $300 for the initial psychiatric
evaluation and $50 per 20 minutes for medication reviews.

Dawn Farm bills one month in advance for services, and expects payment upon receipt. Any
prepaid treatment service dates not utilized will be reimbursed by Dawn Farm.In addition, resi-
dential clients who move into our transitional housing are required to pay a full month’s rent in
advance before he or she moves in.

It is understood that non-payment for services will cause services to be discontinued.

The undersigned have reviewed and agree to abide by this agreement.

________________________________________ _____________________
Responsible Party Date

________________________________________ _____________________
Dawn Farm Representative Date
For additional information contact: Beverly Ghesquiere
Coordinator of Finance & Human Resources

Dawn Farm • January 2010

Dawn Farm • 6633 Stoney Creek Road • Ypsilanti, Michigan 48197 • 734.485.8725