Resident Application

By filling out the sober living resident application at SJRR, you will have taken your first step towards recovery with us. Please be sure to complete ALL the fields in our application. Once submitted, Our Admissions experts will contact you within 2 hours (may take a bit longer during nights and on weekends). From there we will take our time to answer all your questions and address any concerns you have about this big decision. Sober living is a huge step in the recovery process, and we are honored to have the opportunity to walk this path with you! Have questions? Contact SJRR today by calling 866-312-3420.

First Name

Last Name

Email

Phone

Todays Date

Address

Health Insurance

Member ID

Emergency Contact Name

Emergency Conatct Phone

Clean and Sober Date

Submit