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  • Application for Residency

    Your submission of this application in no way commits Life Changes, Inc. to accepting you into the program, nor does it commit you to enter the program. If you do not answer every question of this form, your application WILL NOT BE PROCESSED. If a question does not apply to your situation, enter N/A. Be advised, if you are currently residing in a Nevada Department of Corrections facility filling out this online application will delay the process. You MUST contact your caseworker or Pre-Release specialist for an application for reentry. Please visit our reentry fact page at https://www.lifechangesinc.solutions/reentry.
  • General Information

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  • Substance Abuse


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  • Education & Employment History

  • Medical

    The questions in this section are not used to determine your suitability in the Life Changes program and are never disclosed without your express written consent. Your answers will simply allow us to determine what Life Changes facility best suits your needs should you be accepted to the program.
  • Help & Assistance

    This section will help us determine the type of services you may need while at Life Changes
  • Criminal Justice History


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  • Financial

    Life Changes, Inc. is a fee based program. Unless you have made arrangement to pay for your services through a third party, you are responsible to pay your service fees, including your intake fees. Without a third party payee source, you must have the finances or a reasonable plan to pay your fees. Stating you are "going to get a job" is not considered a reasonable plan. Should you find employment and your employer is willing to verify that you have a concrete start date and provide your rate of pay and pay dates, this MAY qualify you to receive services.
  • Applicant Statement

    Please answer the following questions as mindfully and thoroughly as possible.
  • What three goals do you hope to achieve in the next 90 days?

  • Covid-19

    Upon completion of the COVID-19 self-assessment, if you believe you are at risk of having contracted COVID-19 or have been exposed, please discontinue processing this application and immediately seek medical attention.
  • COVID-19 Self-Assessment Screening

    This tool is not meant to take the place of consultation with your health care provider or to diagnose or treat conditions. If you're in an emergency medical situation, call 911 or your local emergency number.

    Information about COVID-19 is constantly changing. The level of COVID-19 activities varies by community, as does the availability of testing. For current update on COVID-19 and details on testing and other health measures in your area, check with your local public health agency and visit the CDC website at cdc.gov.

  • I understand and agree that I am responsible for my own health and well-being and that it is my responsibility to reach out if I am feeling ill, have symptoms such as a fever, dry cough or am feeling nauseous, lose my sense of taste or smell or any other uncomfortable systems.

    I understand and agree that should I be accepted into the Life Changes, Inc. congregate living facility, it is likely I will initially begin my residency in a quarantine facility and I agree to abide by all requirements of this facility.

    I understand and agree that Life Changes, Inc. operates a congregate model of housing and agree to abide by any and all safety precautions suggested or regulated by the Centers for Disease Control, State of Nevada or Life Changes, Inc. I understand and agree that the COVID-19 pandemic and other health concerns is a viable issue and I will do my part to ensure the safety and well-being of myself, my house mates, staff, volunteers and visitors to the facility.

  • Residential Rules & Code of Conduct

    • Life Changes, Inc. is a suggested 90-day program. The monthly fees for the program are based on which facility best suites your needs. You must either have a third party payee source, or have the ability to pay your intake fees prior to entry.
      • Should you believe you would benefit from an extended stay, this must be requested in writing 30-days prior to your scheduled discharge date. Requests for extention will be considered on a case by case basis.
    • I understand Life Changes is a faith-based program. As such, I agree to attend spiritual services/church. I understand this is a strict requirement of the program and should I be accepted I will comply with this requirement.
    • I understand Life Changes operates a sober living home and drug or alcohol use is strictly prohibited. I also understand and agree to attend self-help meetings such as AA, NA, Celebrate Recovery, etc. while a resident of Life Changes, Inc. I understand this is a strict requirement of the program and should I be accepted I will comply with this requirement.
    • As a Life Changes, Inc. participant, you are expected to comply with the following requirements.
      • Maintain a crime free lifestyle; 
      • Obtain/maintain employment at 40 hours weekly (unless you have a valid medical reason not to do so and your fees are paid and kept current.
      • Pay your service fees, or be responsible for ensuring your designated third party pays your service fees;
      • Access behavioral and physical health services as recomended, and
      • Adhere to all program requirements, including requirements of the criminal justice system. 
    • Rules and Expectations
      • Alcohol/narcotic consumption, gambling, pornography and gang activity are prohibited on or off site as a resident of Life Changes. Non-compliance will result in immediate discharge.
      • All weapons are strictly forbidden.
      • Residents of Life Changes, Inc. agree to random urinalysis and breathalyzer resting.
      • Staff has the right to search your possessions if alcohol, narcotics, weapons, contraband, trafficking or thievery is suspected.
      • Thievery is not tolerated. Residents are responsible for their own possessions. Life Changes, Inc. is not liable for missing items.
      • Violence, including all forms of physical, mental, or emotional violence, intimidation, injury, abuse, negligent treatment, maltreatment, or exploitation, including sexual abuse, or harassment is strictly forbidden. This includes but is not limited to verbal or physical conduct that creates an intimidating, hostile, offensive environment, or sexual in nature directed toward any resident, visitor, staff or volunteer of Life Changes.
      • Smoking is allowed in designated areas only.
      • You may not have visitors in your room. All visitation is to take place in common areas. This applies to other house mates.
      • You may not use the phone for an excessive length of time if another resident needs access.  You must answer incoming calls on call waiting while you are on the phone. 
      • Residents are required to use the sign in/out sheets when leaving the facility. All fields must be completely filled out, legible, include your full name and your time of departure and anticipated return. You must use your legal name, NO NICKNAMES. If you are unable to return at your indicated time, you must contact staff to obtain permission to be late.
      • You are prohibited from eating in your room to ensure the facility stays free from pests
      • In the instance of illness, staff MUST be immediately notified. Residents must disclose to medical personnel that they are in recovery from an addictive disorder and may not be prescribed narcotics. Residents must provide staff with copies of all prescriptions and comply with all medication management policies and safe keeping requirements.
      • Upon discharge, you must remove all of your personal belongings. If your property is not removed within thirty days it will be considered abandoned and will be discarded.  Life Changes is not responsible for items left on property.
      • You are required to attend mandatory self-help, and/or house governance and spiritual meetings.
      • You are required to adhere to curfew as indicated in your blackout, specific criminal justice or Life Changes requirements. 
      • You are required to perform your chores daily, the kitchen is to be cleaned after each use, your bed must be made daily, your personal items put away and any food particles promptly disposed of.
      • You may NOT tattoo, use hair dye, paint, or otherwise perform any activity that may cause damage to another person or the facility.
      • You may not burn candles, incense or use personal space heaters at any time.
      • Do not borrow or loan, this includes money, cigarettes, clothes, personal belongings, food stamps or food.
      • You are required to be out of bed and ready for the day by 8 am MF. If you are employed and working swing shift, this requirement will be modified.
      • You are required to work or go to school a minimum of 40 hours a week. 
      • You are required to pay your service fees and provide copies of your paycheck stubs to staff. Failure to pay your service fees in a timely manner is cause for dismissal.
        • You are required to provide documentation of a legitimate job, with a schedule and set pay schedule. 
  • Your signature below indicates you have read and understand the requirements of placement in the Life Changes, Inc. program. 

  • Clear
  • Admission

    One of our Intake Specialists will be in touch with you to discuss your application, service fees, required deposit and any other questions or concerns you may have. Please keep in mind, if you have not answered all questions on this application for residency, it will not be processed.
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  • Form Submission

    STOP! If you have not answered every question on this form, your application WILL NOT BE PROCESSED. By submitting this application you attest that you have responded to each question truthfully and to the best of your ability, that you have read ALL rules and requirements and should you be accepted you will abide by these rules and requirements.
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