Spain Sober Living Questionnaire 
Please be as thorough as possible
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Email *
https://www.spainsoberliving.com/
Full Name *
 Age *
Phone Number *
Sober Date *
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How would you describe your relationship with family? Is there a certain family member you are closest with? *
If accepted to Spain Sober living, do you consent to Spain staff reaching out to family to develop a relationship? *
Are you Employed? If so, where *
Employed or not, what is your job sector (construction, retail, grocery, etc.) *
If you are not employed, you are required to be out of the house from 10am-3pm on weekdays to focus on job hunting or schooling. Do you have any concerns with this?
What is your drug of choice? What other drugs do you consider yourself to struggle with? *
Which Spain Sober Living House are you interested in? *
Have you been diagnosed with any mental illnesses? If so, please list below.  *
Please list any medications (Including MAT) that you are prescribed. *
Have you been in sober living before? If so, which ones? Please describe your past experience there, whether positive or negative.  *
Would you be willing to commit to at least 90 days? If not, please explain.  *
Just so we can do our best to accommodate our client's to the best of our ability. Do you snore or struggle with individuals who snore?  *
Do you have interest or plans to do IOP? If so, which one. 
If not, why? *
Are you coming from a Treatment Center? If so, which one? *
What is your desired move in/discharge date? *
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DD
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What do you do for fun? What are your hobbies?  *
How would you describe your personality? Are you more introverted or extroverted?  *
Do you have any stressors or triggers that could get in tha way of your recovery? *
What would you like your life to look like sixty days into your residency at Spain Sober Living? *
Would you be willing to submit to a COVID test upon entry? *
Is there anything else you would like to add or anything else we should know about you? *
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