BHIVE Resident Screening
Once your screening is received & reviewed someone will be in contact with you via email or text within 24 hours.
*If for some reason we can't accept you, we will provide you a list of local resources and help where & how we can*
Email address *
Today's Date: *
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First & Last Name: *
Your answer
Date of birth: *
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How did you hear of us? *
Your answer
Phone #: *
Your answer
Where are you staying now?
Your answer
Where are you from? *
Your answer
What drugs are you recovering from? *
Your answer
Recovery Date: *
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We have a TRI (3) Fold Approach to recovery, in which we advocate 12 step recovery, introduce you to a Loving God that you may or may not know, along with structured living. Are you willing to participate within this approach and do your best to keep an open mind and a degree of willingness? (make sure you understand this because we are going to talk about GOD ) *
When do you need in? *
Your answer
Do you have a diagnosis besides chemical dependency or alcoholism?: *
Your answer
Are you on any meds?: *
If so, list them?
Your answer
Have you been in recovery before? *
Longest time clean? *
Your answer
Have you ever been to treatment? *
How many times, if yes to the above question. *
Your answer
Have you been at the BHIVE before? *
If yes, when?
Your answer
Married or in a relationship? *
If married or in a relationship, where are they now?
Your answer
Children? (Insert number) *
Your answer
If children, where are they?
Your answer
Do you have a car? *
Do you have a job? *
If yes, where? *
Your answer
When are your paydays? *
Your answer
Are you on disability or SSI? *
If yes, which one and what for?
Your answer
Are you on probation or parole? *
If yes, what for?
Your answer
Are you a registered sex offender? *
There is a $50 move in fee due immediately, $50 over the next 2 weeks, & $100 each week thereafter ... do you understand & can you agree to this rent policy? *
Situation Summary (Summarize your current situation & hopes). *
Your answer
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