Admissions
Your first step can be a simple conversation.
You can ask about Hope for Women's residential addiction recovery program for yourself or for a woman you care about. The preliminary inquiry is short and is not the full application.
Before you inquire
What you should know.
- Applicants must be women age 18 or older.
- The residential addiction recovery program lasts 12 months.
- The intake fee is $300. Reach out even if this is a barrier.
- Prospective residents are reviewed individually.
- The full application is completed in person.
Medication policies, medical-clearance requirements, current availability, required documents, and move-in details should be confirmed directly with Hope for Women.
Preliminary intake inquiry
Begin the conversation.
Share only the contact information needed to reach you. Please do not include private medical details.
This website and form are not emergency, crisis, medical-detox, or clinical-care services. In an immediate emergency, call 911.
New Client Intake Form
Personal Information
Tell us a little about yourself and how we can contact you.
Recovery Information
This information will help Hope for Women better understand your current situation and determine appropriate next steps.
Health & Wellness
Please provide the information requested below. If none applies, you may enter “None.”
Employment & Education
Tell us about your current ability to work and your employment or educational goals.
Legal Information
Please tell us about any current legal obligations or upcoming court dates.
Additional Information
One final step before submitting your intake form.