Sign Up for Telephone Recovery Support

How does it work?

During this time of social distancing, we would like you to know that we are still here to help you through your recovery process. You can now sign up to have a peer support specialist call you to ensure that you are staying connected. During the call, we will offer you information about resources in the community-if you request. But more importantly, we just want to check in and see how your recovery is going!

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* 1. Tell us a little about yourself?

Name *

Phone Number

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* 2. Is it okay for us to leave a voicemail message on your phone and/or leave a message if another person answers your phone and you are not available?

Yes

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* 3. You need to be at least 18 years of age to participate in Recovery Coaching. Please provide your date of birth.

Date of birth (MM/DD/YYYY)

Date

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* 4. Gender

Male

Female

Transgender

Prefer not to answer

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* 5. So that we can be best prepared to assist you, please let us know if there is something you would like to focus on...

General Recovery Support

Re-building your relationships and social networks

Finding a safe and stable place to live

Creating a Early Recovery Success Plan

Guidance after a recent lapse in recovery

Securing employment that supports your recovery

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* 6. How often would you like a phone call?

Weekly

Daily

Bi-weekly

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* 7. What time of day is best for you to receive a phone call?

Mornings

Afternoons

Evenings

Other (please specify)