RSVP 2 — PR Sober Living

Join Us

Please provide the following information if you’re interested in joining our recovery community.

Name

First Name

Last Name

Date of Birth

Month/Day/Year

YYYY

Phone

(###)

###

####

Please describe your treatment history.

Please tell us why you're seeking sober living.

Please list all substances you have used or abused.

Please list your prescribed medications and any supplements.

Are you employed?

Do you have an AA/NA sponsor?

Please list any co-occurring mental health diagnoses.

Do you have a history of self-harm, suicidal ideation or suicide attempts?

Do you have pending legal charges?

If so, please list charge(s) and date(s):

Do you consent to a background check?

Is there anything else you would like to share?