Sisters of Sobriety Recovery Residence Application

Sisters of Sobriety Recovery Residence Application

Please complete this application in full. Sisters of Sobriety is a recovery residence and not treatment. Residents must be able to self-pay program fees.
We are honored you are considering Sisters of Sobriety as the next step in your recovery journey.

To be considered for acceptance into Sisters Of Sobriety an applicant must fill in this application completely. Carefully read the application and honestly answer the questions. You will find Sisters Of Sobriety a place where you can begin a sober, healthy, productive, and giving life.

*Please note that Sisters Of Sobriety is not treatment, not covered by any insurance and you must have the ability to self-pay.

PROGRAM FEES ARE $640 MONTHLY, AND YOU CAN PAY WEEKLY

*ALWAYS IN ADVANCE*

MUST HAVE $160, (ONE WEEK PROGRAM FEE) AND A SOBRIETY DEPOSIT OF $160 TO MOVE IN, $320 total.

ALL QUESTIONS IN APPLICATION ARE TO BE ANSWERED

IF NOT APPLICABLE PLEASE MARK AS N/A

PERSONAL INFORMATION
Proposed Admission Date*

MonthDayYear
Date
Name*

First NameLast Name
Applicant or Contact Email Address (if available)
example@example.com
Address (Last known address if no address at his time) Indicate which

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County of origin*
YesNo
Date of Birth*

MonthDayYear
Date
Age*
Your Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Alternative Contact
Emergency Contact Name
Emergency Contact Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Relationship

TREATMENT HISTORY
YesNo
Agency Name
Primary Contact
Contact Phone Number and extention
Please enter a valid phone number.Format: (000) 000-0000.
Admission date into residential treatment

MonthDayYear
Date
Discharge date from residential treatment

MonthDayYear
Date
YesNo
Number of times in treatment
Date of last residential treatment

MonthDayYear
Date

MEDICAL HISTORY
YesNo
If yes, please list physical limitions
YesNo
If yes, how do you manage your pain?
YesNo
If yes, list medications and reason prescribed

IDENTIFICATION AND TRANSPORTATION
Valid drivers licenseState IDSocial Security cardFood stamp cardVehicleBringing vehicle to SOSNo VehicleNo identification

INCOME AND EMPLOYMENT
Current monthly income, if none, mark 0*
Source of income, if none, mark N/A*
YesNo
If yes, who is helping and for how long?
YesNo

LEGAL HISTORY
YesNo
If yes, please explain your current legal situation
YesNo
Probation or Parole discharge date
Name of Probation/Parole officer
County of supervision
YesNo
If yes, please explain
YesNo
If yes, next court date
Reason for appearance
You are responsble for arranging and attending all legal obligatisons, court dates, probation, and paroled rquirements while residing at Sisters of Sobriety.

RECOVERY COMMITMENT AND SIGNATURE
What are your personal recovery goals during your time at Sisters of Sobriety?*
I understand that Sisters of Sobriety is a strutured recovery residence and not a treatment or mental health facility.

I agree to follow all house guidelines, remain abstinent from all mood-atering substances, and participate in my recovery plan while at Sisters of Sobriety.

I also agree to participate in Wednsday house meeting and peer recovery support group from 9:00 am to 12:00 pm and Thursday clinical group 10 am to 12 pm.

(These are mandatory mornings to be present at Sisters of Sobriety.)
Yes, I agreeNo
Applicant Signature*

Powered by Jotform SignClear
Date Signed*

MonthDayYear
Date

PREPARING FOR YOUR ARRIVAL AT SISTERS OF SOBRIETY
We are honored to welcome you into a safe, structured, and supportive recovery home. The following information will help you prepare for a smooth and successful transition into the Sisters of Sobriety residence.

Items You May Bring
- Up to 10 days of clothing. All belongings will be searched upon arrival.
  One week of food for personal use.
  Prescribed medications in original pharmacy bottles only.
Items Not Permitted
- Unmarked medication containers or pills in baggies.
  Computers or personal laptops during your stay.
  Energy drinks or instant coffee.
First-Week Communication & Visitation Guidelines
- Phones may be held for the first week (individualized as needed).
  During this time, you may have two 10-minute calls to children, spouse, or sponsor.
  No passes or visits for the first two weeks of residency.
- These boundaries are designed to support stabilization, safety, and early recovery focus.
Transportation & Arrival
- If arriving by bus, Indian Trails drop-off is located at Bulldog Square in Big Rapids, Michigan.
  Please coordinate your arrival time in advance.
What Sisters of Sobriety Provides
- Residents are welcomed into a respectful home environment where basic living needs are supported so each woman can focus fully on recovery and rebuilding her life.
The residence includes:
- Comfortable shared two-bedroom living spaces
  Bedding and shared household necessities
  Kitchen and refrigerator access
  Computers and internet for employment, education, and recovery needs
  A shared home phone for communication
- Everything is intentionally designed to create a stable, dignified place to heal, grow, and move forward with confidence.
Acknowledgment

By continuing with this application, you acknowledge that you have read and understand the preparation guidelines and expectations for entry into Sisters of Sobriety.

We look forward to walking alongside you in recovery.
Yes, I understandNo
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