Follow the steps to fill out the Harvest House application online

1. Press the ‘Get Form’ button to access the application form and open it in your preferred online editor.
2. Begin by entering your full name in the designated section. Use the format: Last Name, First Name, Middle Initial.
3. Select your gender by checking the appropriate box for either Male or Female.
4. Provide your present address, including street, city, state, and zip code. Indicate if this address is for a treatment center or Department of Corrections by checking the corresponding box.
5. Enter your primary phone numbers: home, work, and any other relevant contact numbers.
6. Indicate whether you are an alcoholic or an addict by checking 'Yes' or 'No' for each question.
7. If you answered 'Yes', enter the date of your last drink or drug use. If 'No,' please provide an explanation.
8. Specify your current employment status and provide the name of your employer if applicable.
9. List the number of Alcoholics Anonymous or Narcotics Anonymous meetings you attend weekly and state whether you have a sponsor.
10. Indicate if you receive disability or any other income not related to employment, detailing the sources if you answered 'Yes'.
11. Answer questions about any drugs you use addictively and your mental health support, including the names and contact info of medical providers.
12. Complete the education level section by selecting the highest level achieved.
13. Fill in emergency contact information for your family doctor and two additional contacts with names, relationships, and phone numbers.
14. Acknowledge your understanding of the mission of Harvest House and the rules by signing and dating the application.
15. Review the entire application for completeness, make any necessary changes, and ensure that you have answered thoughtfully.
16. Save your changes, download a copy for your records, or share the completed application as required.

Take the first step toward recovery by completing your application online today.