Prospective Resident Intake

Let's start the conversation.

This form helps us understand your housing needs and whether one of our homes may be an appropriate fit. New Hope Community Homes LLC provides sober housing — not detox, therapy, counseling, or licensed medical treatment. Addresses are shared after screening.

1. Applicant Information
2. Referral / Contact Information
3. Housing & Daily-Living Needs
4. Recovery & Housing Fit

Please do not include diagnoses or detailed medical information — this section is only to understand whether sober housing is an appropriate level of support.

5. Current Housing Situation
6. Employment, Income & Practical Stability

For housing-planning purposes only. Housing fees and any required move-in funds are discussed separately during screening.

7. Emergency Contact
8. Important Screening Information

For safety and fit. New Hope Community Homes LLC does not provide detox, medical care, therapy, counseling, or other licensed treatment.

9. Applicant Goals
10. Applicant Acknowledgment
I understand that completing this form does not guarantee placement. I understand that New Hope Community Homes LLC will review the information provided to determine whether the housing environment may be an appropriate fit. I understand that New Hope Community Homes LLC is sober housing and does not provide detox, medical care, therapy, counseling, or licensed treatment. I understand that additional screening may be required before a move-in decision is made.