Get Client Application - Masada House - Masadahouse

Filling out the Client Application for Masada House is an essential step for people seeking support in their recovery journey. This guide provides clear and comprehensive instructions tailored to help you successfully complete and submit the form online.

Follow the steps to fill out the Client Application effectively.

1. Press the ‘Get Form’ button to access the application and open it in your preferred online editor.
2. Begin by providing your general information. This includes your full name, address, social security number, date of birth, and emergency contact details.
3. Next, address your marital status and provide information about children if applicable. Please note that children cannot be accommodated.
4. Complete the medical health section by listing current medications and any medical issues you may have, along with your physician's contact information.
5. In the mental health section, indicate whether you have a mental health diagnosis, provide details of any medications you are on, and list your mental health provider.
6. Fill out the substance abuse information, including your drug(s) of choice, date of last use, and details of past treatment facilities.
7. Complete the legal information section by detailing any past arrests, current or pending charges, and providing information about your probation or parole officer if applicable.
8. Finally, make sure to answer the personal questions regarding your experiences in transitional living programs, your job status, and your goals.
9. Before submission, review the entire application for accuracy and completeness.
10. Once you are satisfied with your completed application, save your changes, and print or share the form as needed.

Complete your Client Application online now to take the first step in your recovery journey.