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Admission Application

Thank you for your interest in Jacob's Rehabilitation Farm Center. This application helps us learn more about you and determine your eligibility for our residential rehabilitation program. Please complete all sections as accurately and honestly as possible. All information provided will be kept confidential and used solely for admissions purposes.


If you have any questions, please contact us:

Phone: +501 673-5898

Email: info@jacobsrehab.org

Address: Remate Bypass Road, Patchakan, Corozal, Belize Central America


We look forward to assisting you on your journey toward healing, hope, and restoration.

Copyright © 2026 Jacobs's Rehabilitation Farm Center, Inc. All rights Reserved

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