ChoiceRecovery Path

Sober living · Choice Recovery Path

Application for Admission

A place to begin your next chapter. Prepare your sober living application at your own pace.

Download the original blank PDF 3 pages · 177 KB

Review, then send to Choice.

Choose “Send application to Choice” after reviewing to email your application to soberlivingreferrals@choicerecoverypath.com. Entries stay on this page until you send or clear them; closing or reloading clears them. You can also print locally or download the original blank PDF. Use a private device and protect any copy you print or save.

Section A · Completed by applicant

Your sober living application

All sections from the original form are included. Review and local printing allow blanks. Sending requires your name, a phone number or email, entered signature, printed name, date signed and the sending acknowledgment. Review alone does not send.

Sober living application
Applicant Information

Use the date picker or enter a complete date.

Include an area or country code.

Use the date picker or enter a complete date.

Emergency Contact

Include an area or country code.

Substance Use & Housing Needs

Use the date picker or enter a complete date.

Use the date picker or enter a complete date.

Please check appropriate box

Select the house option or options that apply. Availability is not confirmed here.

Physical & Mental Health Assessment

Enter a whole number from 1 to 10, or leave blank.

Disclosure and Consent for Release of Information

The following text is reproduced from the original PDF. Review the full text before deciding whether to sign and send.

I authorize the Sober Living Home and its representatives to obtain and release confidential information as necessary for my application process and continued residency. This may include communication with healthcare providers, treatment centers, probation/parole officers, or other relevant institutions/individuals. All information will be handled in accordance with privacy laws and regulations.

Signature and Date

House Rules and Policies Acknowledgment

By signing below, I acknowledge that I have received, read, and understood the Sober Living Home’s house rules and policies, including but not limited to:

  • Zero tolerance for substance use or possession on the property
  • Respectful behavior toward staff and residents
  • Participation in house meetings and assigned chores
  • Compliance with curfew and visitor policies
  • Immediate notification of staff regarding any incidents or concerns

I agree to comply with all house rules, Recovery Guest Handbook, and understand that violation may result in dismissal from the program.

Typing your signature and choosing to send records your entered signature with this application. The house rules and Recovery Guest Handbook are referenced in the PDF; the handbook is not supplied here. Ask Choice for any documents you need before acknowledging the rules. Nothing is pre-signed or checked for you.

Enter your own signature if you choose to send. Leave blank for an unsigned local printout.

Use the date picker or enter a complete date.

Review your entries

Check your entries and the full terms before sending or printing.