Healing River House — Public Application

Healing River House — Public Application
Women's Recovery Residence | San Antonio, Texas
Client Application Packet
Application status: The public online application is temporarily offline. Please complete this packet and contact Stephanie Anderson directly for next steps.
Send or discuss next steps
Call/text Stephanie Anderson, House Manager and Strategic Operations Consultant, at 817-692-9624. Email: s.anderson@healingriverhouse.com
Program fee details
Introductory rate: $200/week, or $800/month, for the first two months.
Standard program fee: $250/week, or $1,000/month after the first two months.
Required deposit: $200. The deposit is separate from the weekly/monthly program fee.
Scholarship opportunities may be available.
How to complete this packet
Please answer as clearly as you can. If a question does not apply, write N/A. If you are unsure, write what you know right now. This application helps Healing River House understand fit, safety, structure, support needs, and next steps.Healing River House is not a substitute for licensed medical, mental health, detox, or crisis services. If this is an emergency, call 911. For suicidal thoughts or mental health crisis support in the U.S., call or text 988.

1. Basic Information
Full legal name

First NameLast Name
Preferred name

First NameLast Name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Today's date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Phone
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best way to contact you
Best time to contact you
Who referred you to Healing River House?
Emergency Contact
Name

First NameLast Name
Relationship
Phone
Format: (000) 000-0000.
Email
example@example.com
Any immediate safety concerns or urgent needs we should know before speaking with you?

7. Program Fit Acknowledgment
I understand that Healing River House is a structured recovery house and may require participation in recovery-supportive activities, therapy or treatment verification where applicable, work, school, volunteering, meetings, sponsorship, accountability, program rules, and other written expectations. I understand that if Healing River House is not the right fit, or if I am unwilling or unable to follow program expectations, the team may refer me to another house or more appropriate level of support.
8. Participation Acknowledgment
I understand Healing River House is substance-free; meeting attendance, sponsor/step work, program fee payment, curfew, communication, and participation expectations may apply; relapse, dishonesty, refusal of testing, or safety concerns may result in discharge; and Healing River House is not a substitute for licensed mental health, medical, detox, or crisis care.
Applicant Certification
By signing below, I confirm that the information I provided is true to the best of my knowledge and that I understand Healing River House will use this information to discuss program fit, availability, and next steps.
Applicant signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Printed name

First NameLast Name
Phone
Format: (000) 000-0000.

Healing River House Use Only
Date received

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reviewed by

First NameLast Name
Phone screen scheduled

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Tour scheduled

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Status / Outcome
Screening notes
Next steps
Contact for next steps: Stephanie Anderson - House Manager and Strategic Operations Consultant - 817-692-9624 - s.anderson@healingriverhouse.com
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Client Application Packet