Get Recovery Inn New Resident Intake Form - Recoveryinn

This guide provides step-by-step instructions on how to successfully fill out the Recovery Inn New Resident Intake Form online. Whether you are familiar with digital forms or new to the process, this comprehensive guide will help you understand each section of the form.

Follow the steps to complete the online intake form.

1. Press the ‘Get Form’ button to access the form and launch it in your selected editor.
2. Begin by entering your bed number and the date in the provided fields. This information is essential for tracking your intake.
3. Fill in your Social Security number, first name, middle initial, last name, maiden name, date of birth, and age. Ensure all personal details are accurate.
4. Indicate your ethnicity by checking the appropriate boxes provided, including options for Asian/Pacific Islander, White, American Indian, Hispanic, Black, and other.
5. In the relationship status section, select your current status (single, engaged, married, etc.).
6. Provide your most recent address, including street address, city, state, zip code, and the contact phone number. Indicate if messages can be left at this number.
7. Complete the treatment history by noting the number of 12-step groups attended and the duration of sobriety. List any previous treatments and substances abused.
8. Detail your current transportation situation by selecting whether you have your own vehicle or utilizar public transportation. If you have a vehicle, provide the make and year.
9. If applicable, indicate your probation or parole status by marking the relevant boxes and providing the name and contact number of your probation officer.
10. Specify who referred you to Recovery Inn by checking the corresponding boxes and providing the referral name and number, if available.
11. Provide information about your employment status, including the name of the employer and supervisor if applicable.
12. Respond to the questions regarding your past counseling, mental health hospitalizations, substance use, and any history of abuse.
13. Answer the rating scale questions regarding your current concerns, motivation, and optimism. Use the provided scale to rate your feelings.
14. Complete the family history section and provide details about any children you have, including custody information if applicable.
15. At the end of the form, review all your responses for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your Recovery Inn New Resident Intake Form online today to take the next step in your recovery journey.