Assessment | The Guest House Transitional Sober Living

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About
Services
You Can Help
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Contact
2024 Fundraiser

All new residents must remain on the property until a Needs Assessment is completed and all necessary appointments are scheduled. This process should be completed within the first seven (7) days of residency. Residents are not permitted to leave the property for any reason during this time unless there is an emergency and prior approval has been given. Please view our programming options before filling out the assessment.

Date Wanting To Come In *

First name*

Middle Initial*

Last Name*

Phone Number*

Contact Person*

Birthdate*

County of Residence (must provide proof)*

Hancock

Henry

Fayette

Rush

None

How Long Have You Been Homeless*

Reason For Homelessness*

Program TRAC Choice*

Emergency *30 Days

Reentry *Time Varies {Parole, Probation, Drug Court}

Genesis Residential Program *12 Months

Vocational *4 Months {Employed and provide proof before accepted}

Income*

No Income

Part-Time

Full-Time

SSI

Disability

Employer

Are You Currently Incarcerated*

Yes

Do You Have Any Criminal Charges Sexual In Nature*

Yes

Are You Currently On Or Will You Be On*

On Probation

On Parole

On House Arrest

On Drug Court

Does Not Apply

Do You Have Any Serious Health Conditions*

Yes

Have You Been Prescribed Medication For Mental Illness*

Yes

Are You Currently Taking All Medication Prescribed For Mental Illness*

Yes

Does Not Apply

Can You Climb Steps & Practice Personal Hygiene Independently*

Yes

Do You Have A State ID or Jail ID*

Yes

What specifically about our facility made you choose us over other sober living options, and what goals do you have for your time here?*

How do you think a sober living environment can help you achieve those goals?*

What are the main challenges you face, and how do you plan to address them while living here?*

What does "being responsible for your actions" mean to you, and how have you demonstrated this in the past?*

How do you feel about living in a structured environment with rules in place? Can you provide an example of how you've adapted to a structured setting before?*

Get in touch

First Name*

Last Name*

Your email*

Subject*

Message*

The Guest House

1407 Walnut Street
New Castle, IN 47362

(765) 388-2136
info@theguesthousenc.org

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The Guest House

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