Follow the steps to successfully complete your form.

1. Click the ‘Get Form’ button to obtain the form and access it in the editor.
2. Begin with the 'Client Information' section. Fill in your name, entry date, unit address, date of birth, and age. Select your gender by checking the appropriate box.
3. Provide details for your emergency contact, including their name and phone number.
4. Enter the service fee monthly rate, and indicate if you are prorated by selecting 'Yes' or 'No' options.
5. Specify your employment status, length of employment, and the name and address of your employer. Include your employer's contact number.
6. Detail any other funding sources you may have and fill in the name of your case manager and their contact information.
7. Answer the questions regarding your history with chemical dependency treatment, including any programs you have attended, your date of last usage, and your substance of choice.
8. If applicable, provide information about any physical or mental health conditions and the treatment you are receiving. List any prescribed medications, including their names and dosages.
9. Indicate if you are on probation and provide the necessary details along with your criminal history, including any convictions.
10. Review the 'Consent for Services Agreement' and initial each policy section as you agree to them, ensuring you understand all terms.
11. Fill in the sections related to program, general rules, and visitor rules by reviewing and initialing your understanding and agreement to each policy.
12. Finalize your form by signing the document, including the date, and acknowledging your understanding of the rules and responsibilities outlined in the form.
13. Once completed, save your changes, and you can choose to download, print, or share the form as needed.

Complete your documents online now to begin your journey with Sober Solutions Transitional Housing Services.