Get Butterfly House Laconia Nh

Filling out the application for Butterfly House Laconia Nh is an important step for women seeking recovery support. This guide provides a clear and comprehensive approach to completing the form effectively and accurately.

Follow the steps to complete your application form successfully.

1. Press the ‘Get Form’ button to obtain the form and open it in your online editor.
2. Start by entering your name in the designated field alongside the date of your application.
3. Provide your phone number and date of birth in the corresponding sections.
4. Fill out your complete address in the address section, ensuring accuracy.
5. List your emergency contact details, including their full name and contact information.
6. Indicate how you learned about Butterfly House by selecting or writing in the source.
7. Answer the question about being asked to leave a sober house or treatment center, and explain the reason if applicable.
8. If you have a history of eviction, specify the reasons in the provided section.
9. Detail when you last used drugs or alcohol to provide context for your recovery journey.
10. If applicable, mention any pharmaceutical-assisted maintenance or replacement treatment you are currently undergoing.
11. List any physician-prescribed medications you are taking, ensuring you include all required information.
12. Identify any known allergies to medications, foods, animals, latex, or other substances.
13. Disclose any medical conditions or physical disabilities that Butterfly House should be aware of.
14. Mention any mental health issues or disabilities relevant to your application.
15. Provide information regarding your medical insurance in case of emergencies.
16. Indicate your marital status and the number of children you may have.
17. Declare any outstanding warrants, pending criminal charges, or court dates.
18. Answer whether you are on probation, parole, or have a suspended sentence.
19. Confirm whether you are a convicted sex offender or are required to register in any state.
20. If applicable, explain your history of violence.
21. State if you are currently subject to an order of protection, detailing any relevant information.
22. Describe your current employment situation, indicating where you work and how long you have been employed.
23. Specify if you have a valid driver's license and whether you will require parking.
24. Thoroughly describe your addiction history, emphasizing significant details.
25. Share your treatment and recovery history, so Butterfly House can assess your journey.
26. Discuss the biggest challenges you face in staying clean and sober to provide context.
27. Explain how you expect a sober house to aid your recovery efforts.
28. Identify personal qualities you will contribute to community living.
29. Note any reasons that might make it difficult for you to follow the rules and expectations of Butterfly House.
30. Address any trouble you may have getting along with others, selecting from the provided list or mentioning your own experiences.
31. Share any reservations you have about practicing the 12-step program.
32. Finally, certify that all information is accurate and sign the application, including the date.
33. Review the admission process checklist to ensure you have completed all necessary steps and include your deposit and first week's rent.

Complete your application online to take the first step towards recovery.