Women - Application for Admission
  • Application for Admission

    RSM Women's Residential Recovery Program
  • Terms & Conditions

    You must agree to the following to participate in our residential recovery program. If you are unwilling to do so, RSM may not be the best fit for you. Fields marked with an asterisk, "*", are required.
  • For a printable application, click here. If admitted, you will still need to fill out the application online before or upon arrival to the program.

    IMPORTANT – PLEASE READ BEFORE YOU APPLY:

    Our program is fully faith-based. While many programs may include faith as a component, we want to be very clear that everything we do revolves around God’s Word. We believe that true and lasting recovery comes through a personal relationship with Jesus Christ and learning how to walk out His Word in our daily lives.

    We do incorporate teachings that address psychological, mental health, and emotional health, but all of these teachings are always brought back to Scripture. The Bible is our foundation and final authority, and we approach healing, recovery, and transformation through a biblical lens.

    Another important part of our program is daily corporate prayer. Every morning, we wake up, get ready, and go to the War Room. During this time, we pray out loud together for 20 minutes. Participation in out-loud prayer during this time is required.

    After that, there is a 10-minute period of silent prayer, where you may pray quietly or simply sit in silence and listen to the Lord.

    If you are not comfortable praying your own prayers out loud yet, we do provide a prayer manual/journal that you can read directly from until you feel more confident praying on your own. You are not expected to have perfect words — obedience and willingness are what matter.

    This program is not a good fit for everyone, and that’s okay. We believe in being upfront so you can make an informed decision. If you are willing to submit to a structured, Christ-centered environment, this program may be a strong fit for you.


    Our program is a 12-month commitment with three phases.
    ✅ Structured Environment:
    Very structured, disciplined, and intensive. You must say “yes ma’am” and “no ma’am,” ask permission to go to the restroom, and follow strict rules designed to help you become a respectful, successful woman who can thrive in life.

    ✅Work Expectations Disclaimer
    Recovery Soldiers Ministries is a working recovery program. All participants are required to engage in work therapy for a minimum of 8 hours per day. This includes standing for extended periods, walking, lifting, cleaning, and other physical tasks as assigned. If you are unable or unwilling to perform consistent, full-time work activity, or have physical limitations that prevent you from standing or being on your feet for long periods, please discuss this with our admissions team before acceptance into the program.


    ✅ There’s Three Phases, Phase 3 is Significant (last 6 Months of the year):
    You will step into a leadership position at month 6. During this time:
    • You will receive a paycheck every two weeks.


    • You will learn how to budget and manage your money.


    • You will start going on home passes.


    • You will be allowed to have a cell phone.




    ✅ This is a faith-based, spiritual environment. You will be learning about Jesus every day through prayer, worship, Bible study, and classes.


    ✅ Our program focuses on inner healing—working through trauma, past pain, and the root reasons why you turned to addiction. We are committed to helping you heal from the inside out, not just stop using substances.


    ✅ No relationships with boyfriends or girlfriends are allowed. You may only communicate with a spouse you are legally married to.


    ✅ No contact with your family/spouse for the first 30 days. After 30 days, you may have one phone call per week, one visit per week, and you can write letters right away.


    ✅ No smoking, vaping, or dipping. No nicotine is allowed.


    ✅ Phones:
    You will not be allowed to have a personal phone during the first 6 months of the program. In Phase 3 (Final 6 Months), you will be issued a phone by the program that you can use responsibly while learning to handle your freedom.


    If you agree to these terms and feel ready for real change, please reply with your answers to the questions below. If you don’t know an answer, just say “not sure” or “N/A.” 

  • Demographic Face Sheet

  • Format: (000) 000-0000.
  •  - -
  • Format: (000) 000-0000.
  • Health Insurance Information

    RSM utilizes state licensed counselors and CPRS as part of your recovery program. These services will be billed through your insurance as applicable.
  • Legal Status

  • Health

  • Consent and Privacy

  • HIPAA Information and Patient Privacy Consent

    Our Notice of Privacy Practices provides information about how we (“the Practice”) may use and disclose protected health information about you (aka “Patient”). The Notice contains a Patient Rights section describing your rights under the law. You have the right to review our Notice before signing this Consent. The terms of our Notice may change, and if so, you may obtain a revised copy by contacting our office. 

    You have the right to request that we restrict how protected health information about you is used or disclosed for treatment, payment or health care operations. We are not required to agree to this restriction, but if we do, we shall honor that agreement. 

    By signing this form, you consent to our use and disclosure of protected health information about you for treatment, payment and health care operations. You have the right to revoke this Consent, in writing, signed by you. However, such a revocation shall not affect any disclosures we have already made in reliance on your prior Consent. Recovery Soldiers Ministries provides this form to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 

    The patient understands that: 

    • Protected health information may be disclosed or used for treatment, payment or health care operations. 
    • All other disclosures by Recovery Soldiers Ministries will require specific authorization by you unless required by law. 
    • Recovery Soldiers Ministries has a Notice of Privacy Practices and that the patient can review this Notice and receive a copy. 
    • Recovery Soldiers Ministries reserves the right to change the Notice of Privacy Policies. The new policy will be available upon request from our office. 
    • You have the right to restrict the uses of their information used for treatment, payment or operations, but the Practice does not have to agree to those restrictions.
  • I furthermore give Recovery Soldiers Ministries authorization to disclose information about my program progress to my immediate family. This statement of consent is subject to revocation by the patient at any time, except to the extent that the ministry of person who is to make the disclosure has already acted in reliance on it.

  • Receipt and Acknowledgement of Privacy Practice Notices

     

    Our Notice of Privacy Practices (NPP) is available by clicking here: NPP

     

    I hereby acknowledge that I have received and have been given an opportunity to read a copy of the Recovery Soldiers Ministries Notice of Privacy Practices. I understand that if I have any questions regarding the Notice or my Privacy Rights, I can contact Recovery Soldiers Ministries.

  • Social Media Consent Form

     

    Recovery Soldiers Ministries is pleased to participate in social media outlets such as Facebook, Instagram, YouTube, Google+, etc. Through these venues, we share pictures, updates, testimonies, and other inspiring and helpful information that may benefit our donors, partners, and families of those in the program. With the expressed permission of our program participants, we are pleased to share posts congratulating students on accomplishing their goals and completing the program.


    I give my consent to allow Recovery Soldiers Ministries to post updates, videos, or photographs of me on social media.

  • Affirmation

    By signing my name below, I hereby state that I have answered all the questions on this form with complete truth and to the best of my ability. The name I have provided is my name and I have completed this form either independently or voluntarily through a second party.

  • Clear
  •  - -
  • Should be Empty: