APPLICATION

APPLICATIONtruhealing2024-07-17T09:38:19-04:00

Application

Name*
First Last
Maiden Name (if applicable)
Date of Birth*
MM slash DD slash YYYY
Date Seeking Move-In*
MM slash DD slash YYYY
Gender*
Phone*
Email*
Current Address*
Street Address Address Line 2 City State ZIP Code
Date From*
MM slash DD slash YYYY
Date To*
MM slash DD slash YYYY
Are you Currently Receiving income? What type of Income?*
Are you a person who is registered on any Sex Offender Registry, is required to be registered on a Sex Offender Registry or has a history of Arson related charges?*
- Yes
- No
Emergency Contact Name*
First Last
Emergency Contact Phone
Emergency Contact Email
Do you have a history of, or a current problem with substance abuse?*
What date did you last use illicit substances / alcohol:*
MM slash DD slash YYYY
Substance(s) Used:*
Number of times in last 30 days?*
Are you currently engaged in substance use / mental health treatment?*
If so, where and what level of care:*
Are you interested in starting/maintaining a lifestyle without illicit drugs or alcohol?*
Are you interested in starting/maintaining a lifestyle without illicit drugs or alcohol?*
Are you in recovery and prepared to live in a recovery housing environment?*

Inquiries Keep It Simple House

You’ve Got Questions And We’ve Got Answers. Please Reach Out And We’ll Get Back To You As Soon As Possible.

Our Residences

KISH

We’ve got Multiple Locations!

KISH Toledo, OH
(186 Resident Capacity)
419-764-9210

KISH North Baltimore, OH
(32 Resident Capacity)
419-857-8000

Email us at mward@contactkish.com

Why is sober, structured living important?

Sober, structured living is important for individuals in recovery because it provides a stable and supportive environment to continue their journey towards sobriety. Living in a structured setting helps individuals establish healthy routines and habits that promote long-term success in maintaining sobriety.

Structured living also offers accountability and support from peers who are also committed to living a sober lifestyle. It creates a sense of community and camaraderie among residents, fostering connections that can help individuals navigate the challenges of recovery together.

Additionally, sober living environments often offer resources such as counseling services, educational programs, and job placement assistance to help residents rebuild their lives after addiction. This holistic approach addresses not only the physical aspects of substance abuse but also the emotional and psychological factors that contribute to addiction.

Overall, sober, structured living provides a safe and nurturing space for individuals to heal and grow as they work towards achieving lasting sobriety.

At KISH, we are committed to helping those in recovery create and live sustainable sober, healthy lives. Call us today!

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