• GWP Intake Form

  • Welcome to GWP Recovery Ministries

    Our mission is to disciple men and women struggling with addiction, equipping you with the teachings of Jesus Christ to empower you to further the work of the Kingdom here on earth. We achieve this through the practical application of biblical principles and the 12 steps of recovery.

    At GWP, we have a structured level system designed to support your recovery journey. When you first arrive, you will be on full restrictions. As you progress through the levels, you will gain both privileges and responsibilities, as outlined below.

    We look forward to partnering with you in your recovery and helping you grow in your relationship with Jesus Christ.

  • Level System Overview

    Level 1: New Disciples


    Privileges:
    - Use of the house phone
    - Weekend visits from approved visitors (Weekends 1-4)

    Restrictions & Responsibilities:
    - No pass time
    - No cell phone
    - At least 10 hours of service work per week for GWP
    - Obtain a job
    - Complete next steps
    - Must be with staff at all times except when working
    - Must get a sponsor

    Level 2: Completed 30 Days on Level 1


    Criteria:
    - Follows all rules and completes chores in a timely manner
    - Good attitude and full participation in activities and meetings
    - Has a sponsor and is working the steps
    - Has a full-time job

    Privileges:
    - 16 hours pass time (split into two 8-hour passes)
    - Buddy system
    - May have a cell phone between 6 am - 9 pm (discretion of staff, 3rd step required)

    Restrictions & Responsibilities:
    - Continue step work (complete steps 1-3 before advancing to Level 3)
    - Daily devotion to step work, Bible study, prayer, and devotion
    - No overnights

    Level 3: Completed 60 Days at GWP


    Criteria:
    - Good attitude and willingness to work on relationships within the house
    - Manages phone and computer time wisely
    - Takes initiative and shows responsibility
    - Follows all rules with minimal follow-up from staff
    - Paid all back pay and up to date on rent
    - Developed a financial plan and working towards financial independence
    - Works faithfully with a sponsor and completed steps 1-3

    Privileges:
    - May have a cell phone between 6 am - 9 pm (3rd step required)
    - 24 hours of pass time per month (split into three 8-hour passes)

    Restrictions & Responsibilities:
    - Turn in phone at 9 pm each evening
    - Make wise choices with pass time and cell phone use
    - Continue working steps (complete steps 4 and 5)
    - Daily contact with a sponsor
    - No overnights
    - Buddy system required

    Level 4: Completed 90 Days at GWP


    Criteria:
    - Great attitude and willingness to continue learning and growing
    - Consistently follows rules, demonstrates integrity, accountability, and responsibility
    - Significant progress towards all goals
    - Displays emotional maturity and wise decision-making
    - Demonstrates leadership and willingness to help others

    Privileges:
    - May have a cell phone all the time
    - Personalized Reconciliation Plan with a staff member
    - 48 hours pass time (split into two 24-hour passes per month)
    - No buddy system
    - Vehicle eligibility with Life 360 (5th step required)

    Restrictions & Responsibilities:

    - Make wise financial choices, follow the established budget, and ensure timely payment of all rent, fees, fines, and child support

    - Form a helping relationship with a new disciple/resident as a peer mentor
    - Act as a leader in the church/community/GWP
    - Complete steps 6 and 7 with a sponsor
    - Daily communication with a sponsor
    - Chair two outside meetings

    Level 5: Completed 120 Days at GWP


    Criteria:
    - Positive, helpful, and willing attitude
    - Follows rules and helps others learn them positively
    - Takes suggestions, works with a sponsor, understands the principles of recovery, and is ready to finish the steps (completed steps 6 and 7)
    - Displays maturity, responsibility, and leadership consistently
    - Trusted to make great choices

    Privileges:
    - May have a car at the house and drive to/from work and meetings
    - May set own schedule within responsibility boundaries
    - Work with a staff member to develop an exit plan
    - 96 hours pass time (split into four 24-hour passes)

    Restrictions & Responsibilities:
    - 9 pm curfew (unless on an overnight pass)
    - Attend a church service on Sunday
    - Attend 5 meetings a week
    - Continue working with a sponsor and completing step work
    - Make steady progress in achieving goals and exit plan steps

    **Residents after 6 months who manage Level 5 responsibly and complete their 12 steps may be eligible to serve as "Resident Staff." Resident Staff are not subject to pass time rules or restrictions.**

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  • Guidelines

  •  1. Admissions are based on space availability at the time of request. Beds will not be held; first come, first served.

    2. A photo ID and social security card copy must be placed on file. A copy of a birth certificate may also be placed in the file.
    3. **Cardinal Rules:** No non-prescription drugs, alcohol, or substance abuse at any time or place. No smoking or vaping in the house. No pornography, theft, violence, weapons, or gambling. This is a ZERO tolerance for violence program.
    4. No sexual activity on the premises.
    5. All medication (prescription or non-prescription) must be turned over to the staff member on duty and will be kept in the office. All prescriptions from doctors must be given to the staff on duty to be filled. No use of controlled substances (e.g., gabapentin, narcotics, benzodiazepines, opiates). No diet pills or weight loss supplements. All medications MUST be taken as prescribed.
    6. Residents must be at their designated place (e.g., work, church, family). Violators will be dismissed. Any dismissed resident has the right to appeal the decision to the Board of Directors.
    7. Each resident is responsible for maintaining the house, including completing assigned chores and initialing the chore sheet each time the chore is performed.
    8. Each resident is required to get a job. Residents will work 40 hours per week at a first shift job and CANNOT work on Sundays.
    9. All church events are mandatory.
    10. Residents must attend AA/NA meetings when not attending the above-referenced church services and other mandatory meetings.
    11. Good personal hygiene is required. Personal hygiene products are provided to new residents. Rooms must be kept neat, and beds must be made when not in use.
    12. There will be 24-hour supervision on and off the premises unless otherwise scheduled (work, passes) for all disciples on Level 1. A Level System determines passes and privileges. As residents demonstrate reliability and accountability, they can move up in the Level System based on attitude, required duties, and length of stay. Passes can be declined at the Administrator’s discretion. Drug tests will be done upon return from pass. Any items acquired during the pass that are brought back to the premises will be searched, as well as residents' bags or other personal items. If any drugs or paraphernalia are found during this search, the resident will be automatically dismissed from the program.
    13. Staff must be treated with courtesy and respect. They are here to help and must be obeyed. Each person should respect all others, whether resident or staff. Mistreating others will result in disciplinary action (loss of pass or phone, fines, or more serious infractions, dismissal).
    14. Each resident is subject to random drug screens and searches of person and possessions, including mail and purses. Drug tests will be given randomly with residents standing in a line without leaving it. Leaving the line will result in dismissal. Night checks may occur by staff on duty.
    15. Visitors are allowed on Saturday or Sunday from 1:00 pm until 4:00 pm. Exceptions to this rule may be made by the Administrator based on individual cases. Visitors may attend any church functions held any day of the week. All visitors will be given a set of rules to follow. Unruly visitors or those causing problems will be asked to leave and not return without action by the Board of Directors. Each visitor will be interviewed by a staff member. If the staff member on duty feels a visitor is on drugs or has drugs, the visitor must submit to a mandatory drug test and pay $25.00. Failure of the drug test or refusal to take the test will result in the visitor being required to leave the premises and not return. Visitors are not to park on the grass, but in the lot, being careful not to block anyone in. A person bringing something to a resident at a time that is not visitation may give a brief hello but must not stay.
    16. Residents must get their medicines and turn in their phones by 9 p.m. if applicable and be in their room and lights out by 10:00 p.m. each night except on Fridays when the staff person on duty sets the time. Curfew is at 9:00 pm Sunday through Thursday, and 10:00 pm on Friday and Saturday. Residents may get up each day at 6:00 a.m. Morning devotion time is at a time determined by disciples’ work schedules M-F and 10:00 am on Saturday and Sunday. Devotion time is required. Immediately following devotions, residents will make their beds and get dressed for the day.
    17. All requests for visitors, pass time, and sponsor visits must be submitted to the house manager in writing at least 24 hours before the requested date.
    18. Staff reserve the right to determine what is appropriate dress code at any time.
    19. GWP supplies toiletries, cleaning supplies, etc. Cigarettes and other non-necessities are not provided.
    20. Money may not be loaned or borrowed from other residents.
    21. House phone privileges may vary depending on the level system. All residents must be off the house phone by 9:00 pm. If a call is beeped in while a resident is on the phone, it must be answered, and if important or for a staff member, the call must be terminated. The call can be resumed later. An exception may be made for business calls. The beep must be noted, and the person for whom it was intended must be notified. If a phone call agitates or stresses a client, it will be terminated.
    22. Personal cell phone usage will be determined by the Level System and the administrator's discretion.
    23. Residents must ask permission before leaving the building.
    24. No resident shall turn off an alarm or adjust the thermostat without permission.
    25. All residents shall sleep in their assigned room—no exceptions.
    26. When leaving the facility, the sign-in/sign-out sheet must be filled out. All lights, radios, TVs, fans, etc. will be turned off. Each person is to be ready when it is time to leave. Consistently causing others to be late will result in loss of privileges.
    27. All children must have their guardian or another adult present when they are here in case of an emergency. Someone must be here in case of an emergency, either a disciple or another adult. If a disciple has an emergency, all guests must leave the facility. Exceptions may be made for visiting hours of children.
    28. Food should be consumed and stored in the eating area only. Food should be stored properly. No food is allowed in the bedrooms. Water bottles with closeable lids are allowed in bedrooms but must be discarded properly daily.
    29. At NO time are dirty dishes to be left in the sink.
    30. Any resident that shows signs of inability to manage caffeine intake may be counseled by staff.
    31. You may only be in another resident's room when they are present.
    32. All residents who smoke are to do so only in the designated area. Cigarette butts and ashes must be disposed of in a container, not on the ground. Everyone is responsible for ensuring their guests who smoke obey the rules. Those who smoke in the house will be dismissed.
    33. There must be a receipt for all purchases. Shoplifting is unacceptable.
    34. Residents must volunteer at least 10 hours for GWP.
    35. If a resident leaves involuntarily, they will have 2 weeks to pick up their property, or it will be donated to GWP. If money is owed to the program, the property will be kept until the balance is paid.
    36. Mandatory House Meeting once a week.
    37. Men and women in the program are not allowed to associate at all—no contact whatsoever.
    38. The Administrator reserves the right to amend these guidelines, as well as pass time policies and level system rules as needed on an individual case-by-case basis.

    39. No cussing around Pastor Zach or Pastor Jerrold.

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  • Client Information

  • Assessment Details:
    Assessment Date:   Pick a Date 
    Date of Arrival:   Pick a Date 
    Source of Referral:      

    Personal Information:
    Full Name:         
    Security #:      
    Birth Date:     Pick a Date   
    Age:       
    Sex:          
    Race:          
    Hispanic:      
    Preferred Language:           
    Interpreter Needed:      

    Marital Status:      
    Children:      
    Ages:      
    Custody:        

    Education:
    Ability to Read & Write:      
    Highest Education Level:      

    Release of Information (ROI) Contacts:

    Contact 1:
    Name:      
    Relationship:      
    Address:      
    Phone #:            
    Permission to Contact:      
    Contact 2:
    Name:      
    Relationship:            
    Address:            
    Phone #:               
    Permission to Contact:         

    Military Service:
    Military Service:        
    Military Status:      


    Medical History:
    Medications:      
    List:      
    Medical Insurance:      
    Carrier:      
    Medical Problems:      
    Explain:      
    Pregnant:      
    Due Date:   Pick a Date   
    Physical Disabilities:      
    Explain:      
    Special Needs:      
    Explain:      
    Mental Health Diagnosis:      
    Explain:      

    Legal History:
    Currently on Probation:      
    Agency:      
    Year:     
    Charge:   
    Probation Officer Name:   
    Sexual Offense Charges:       
    Registered Sex Offender:        
    Unresolved Legal Matters:      
    Explain:    
    Felony Non-Drug Convictions:      
    Felony Drug Convictions:      
    Explain:   
    Misdemeanor Non-Drug Convictions:      
    Misdemeanor Drug Convictions:


    Employment:
    Current Employment:      
    Start Date:   Pick a Date   
    Weekly Hours:      

    Transportation:
    Transportation:      
    Driver’s License:      
    DL#:      

    Signatures:
    Client Signature:      
    Date:   Pick a Date   

  • Model Notice to Individuals Receiving Substance Abuse Services

  • No provider of substance abuse services receiving Federal funds from the U.S. Substance Abuse and Mental Health Services Administration, including this organization, may discriminate against you based on religion, a religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice.

    If you object to the religious character of this organization, Federal law gives you the right to a referral to another provider of substance abuse services. The referral and your receipt of alternative services must occur within a reasonable period after your request. The alternative provider must be accessible to you and capable of providing substance abuse services. The services provided to you by the alternative provider must be of a value not less than the value of the services you would have received from this organization.

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  • Release of Claims

  • This Release of Claims (the “Release”) is entered into on this [Date] by and between [Client’s Full Name] (the “Volunteer”) and GWP Recovery Ministries (“GWP Recovery Ministries” or the “Organization”).

     WHEREAS, the Volunteer has chosen to participate in volunteer activities (the “Activities”) organized by GWP Recovery Ministries, including but not limited to [brief description of volunteer work, e.g., community service, charitable events, physical labor, etc.];

     WHEREAS, the Volunteer acknowledges the inherent risks associated with the Activities, including but not limited to [describe specific risks, e.g., physical injury, accidents, exposure to hazardous materials, etc.];

     WHEREAS, the Volunteer voluntarily desires to release GWP Recovery Ministries from any and all claims arising from participation in the Activities;

     NOW, THEREFORE, in consideration of being permitted to participate in the Activities, the Volunteer hereby agrees as follows:

     1. Assumption of Risk

    The Volunteer understands and acknowledges that participation in the Activities may involve risks of physical or emotional injury, illness, death, or property damage. The Volunteer assumes all risks associated with participation in the Activities, whether known or unknown, including those caused by the actions or negligence of GWP Recovery Ministries, its employees, agents, volunteers, and representatives.

    2. Release and Waiver

    The Volunteer, on behalf of themselves and their heirs, executors, administrators, and assigns, hereby releases, waives, discharges, and covenants not to sue GWP Recovery Ministries, its directors, officers, employees, agents, volunteers, and representatives (collectively, the “Released Parties”) from any and all claims, demands, damages, actions, causes of action, or suits of any kind or nature, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the Volunteer, or to any property belonging to the Volunteer, while participating in the Activities, regardless of whether such loss is caused by the negligence of the Released Parties.

    3. Indemnification

    The Volunteer agrees to indemnify, defend, and hold harmless the Released Parties from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney’s fees, arising out of or related to the Volunteer’s participation in the Activities, including but not limited to any claims related to the Volunteer’s negligence or intentional misconduct.

    4. Medical Treatment

    The Volunteer consents to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during the Activities. The Volunteer releases and discharges the Released Parties from any and all liability for any first aid, medical treatment, or other services rendered in connection with the Volunteer’s participation in the Activities.

    5. Insurance

    The Volunteer acknowledges that GWP Recovery Ministries does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. The Volunteer is expected and encouraged to obtain their own medical or health insurance coverage.

    6. Photographic Release

    The Volunteer grants GWP Recovery Ministries the right to use their image, likeness, and voice in photographs, videos, or other media for promotional, educational, or other purposes related to the mission of GWP Recovery Ministries without compensation.

    7. Governing Law

    This Release shall be governed by and construed in accordance with the laws of the State of [State], without regard to its conflict of law provisions.

    8. Severability

    If any provision of this Release is found to be unenforceable or invalid, the remaining provisions shall remain in full force and effect.

    9. Acknowledgment of Understanding

    The Volunteer acknowledges that they have read and understood this Release, fully understand its terms, and are signing it freely and voluntarily. The Volunteer understands that by signing this Release, they are giving up substantial rights, including the right to sue the Released Parties.

    IN WITNESS WHEREOF, the Volunteer has executed this Release as of the day and year first above written.

     

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  • Consumer Right and Responsibilities

  •  Consumer Rights

     1.  Consumers have a right to be treated with dignity, respect, courtesy and professionalism.

    2.  Consumers have a right to a prompt assessment and to have the results shared in a timely manner.

    3.  Consumers have a right to participate in the development of a plan for services and to have copies of it.

    4.  Consumers have a right to file a grievance if it is felt that harm or neglect, in any form, has been displayed.

    5.  Consumers have a right to have their grievance settled in a timely manner, and in a manner that is consistent with the grievance.

    6.  Consumers have a right to inspect and receive a copy of their confidential records.

    7.  Consumers have a right to question staff about services being delivered, and to have the questions answered in a timely manner.

    8.  Consumers have the right to change providers during the course of the services being offered.

     

    Consumer Responsibilities

     

    1.  Consumers have a responsibility for participating in the services agreed upon.

    2.  Consumers have a responsibility to communicate with program staff/volunteers concerns they are having about services being offered.
    3.  Consumers have a responsibility to inform program staff/volunteers of any change in their circumstance or desire to change providers.

    4.  Consumers have a responsibility to actively participate in their recovery from alcohol or drug abuse or addiction/.

    5.  Consumers have a responsibility to not be under the influence of alcohol or drugs while a resident in the program and to inform staff/volunteers if under the influence.

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  • House Program Fee Agreement

  • I         agree to pay the fees set forth in this agreement while in the GWP Recovery Ministries transitional living program. The fees for programming, housing, supervision, transportation, hygiene supplies, food and other necessities are $250 per week. We understand that most of our clients are living at or below the poverty level and that many have no income at all. 

    If I do not have the money each week while not working, the $250 will accrue as “Back Pay” and must be paid. 

    I will pay at least $300 a week after I am employed until the "Back Pay" amount is caught up to a zero balance. If grant funds or donations are available to make up that amount it will come off total payment from weeks in placement at the program. The remaining $100 each week, of those funds will go toward any "Back Pay". 

    I will pay on my back pay as soon as I gain employment in the amount set by the program administrator.

    I understand that if a remaining balance is due, I will not receive completion certificate from the program.

    I will be eligible to graduate from this program provided I have paid the balance of my program. and completed requirements for graduation.

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