Peer Support Academy PRSS/PRC Application
**UPDATED:  If you are interested in signing up for Virtual Recovery Coach Training through Peer Support Academy, please complete this application and submit ASAP.**

Welcome!  We are excited that you are interested in the Peer Recovery Support Specialist/Recovery Coach  training program!  Please  complete this application in it's entirety.

Our Admissions Staff will contact you soon to schedule the Intake Interview.  If you have any questions, please contact us at 208 352 0535 or email us at info@peersupports.academy.
Sign in to Google to save your progress. Learn more
Email *
Name *
Please provide your first and last name.
Organization (if applicable)
Phone # *
Address *
Are you in Recovery? *
Some states offer both Peer Recovery Specialists/Coaches and "allies" - or individuals who are not personally in recovery from substance use disorder and/or other behavioral health disorders - but wish to provide recovery support services.
If in Recovery, what is your Recovery date?
MM
/
DD
/
YYYY
If in Recovery, how do you maintain your recovery?
Can you pass an Enhanced Background Check? *
A Criminal History will not necessarily prevent you from passing a background check.  You can find out more about background check criteria at:  https://chu.dhw.idaho.gov/    and at http://healthandwelfare.idaho.gov/Portals/0/Medical/SUD/DBHWaiverFAQ.pdf                                                                                Still have questions?  Please contact us at 208 352 0535 or email us:  info@peersupports.academy
Are you familiar with the state and/or federal requirements for certification as a PRSS/CPRC?                                                IBADCC http://ibadcc.org/                         NAADAC  https://www.naadac.org/ncprss *
Will you be seeking Certification as a NCPRSS/CPRC? *
Will you be able to provide two (2) character reference letters in support of you attending Peer Supports Academy? *
Have you read the NAADAC NCPRSS Code of Ethics and IBADCC Recovery Coach Code of Ethics? *
The NAADAC NCPRSS Code of Ethics can be found here:  https://www.naadac.org/ncprss-code-of-ethics                                    The IBADCC Recovery Coach Ethics can be found here (Starting on page 27)  http://ibadcc.org/new_web/certification/crc/PCRC_Manual_Claudia_Jen_provisionary-FINAL-050319.pdf
If accepted into the PRSS/PRC training program, do you agree to abide by the NAADAC NCPRSS and IBADCC Recovery Coach Code of Ethics?   *
Have you ever worked and/or volunteered in the Recovery field? *
Do you plan to utilize your training in a volunteer or employment capacity? *
Which workplace environment interests you? *
Check all that apply.
Required
Peer Recovery Support Specialists/Peer Recovery Coaches are required to be supervised by a certified Recovery Support Services Supervisor.  Do you agree to meet with a certified recovery support services/recovery coach supervisor at least twice a month and for no less than 4 hours per month? *
What does the term "multiple pathways to recovery" mean to you? *
Can you support your client's right to choose their own path to recovery, even if you may or may not agree with their choices? *
Why do you want to be trained in peer supports and/or work in the peer-based recovery support services field? *
Is there anything else that you would like to add to your application today?  If so, please tell us in the space below.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of PEER Wellness Center, Inc..

Does this form look suspicious? Report

Google Forms