MEN'S RECOVERY APPLICATION

Men's Adddiction Recovery Program Application

To be eligible for the addiction recovery program at Harvest House Atlantic, you must:

  • Be 21 years or older, and suffer from life controlling addictions such as: alcohol or drugs among others.
  • Understand that we are not a detox facility; therefore, clients may be required to complete a certified detoxification program prior to entry.
  • Complete a drug screening upon entry into the program.
  • Complete an interview with the Recovery Program Manager.
  • Be committed to receiving long term care.
  • Be open to Faith in Christ principles that aid in recovery.
  • Be cognitively and physically able to participate in programming.

Provide full and complete answers to every question. If a question does not apply to you answer "N/A". Incomplete or misleading information will influence your application and/or stay in the program. If you require assistance in completing the form please call our office at 506-855-0626 between the hours of 10am - 3pm.

Please provide either your phone number and/or your email address.

Citizenship

Do you children?

Do they currently live with you?

Are you currently taking prescribed medications?

Are you currently involved in any pending court cases?

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