Lead Form

BSM Sober House Application

BSM is a faith based program with mandatory meetings on Tuesday evening and Thursday nights, along
with other meetings and volunteer work required. We do not accept Methadone or most mood alterning perscription medications.  We do accept Suboxone and Medical Cannabis. 

Please follow up with one of our Intake Coordinators once you submit your application by calling us at: 763-732-0811 or emailing: bsmgetsober@gmail.com 

Name: Client first nameClient last name

Age: Text field

Phone to reach you now: Client phone

Phone to reach you upon release:Text field

Treatment Center: TreatmentCenterHistory

Counselor Name: Contact

Conselor Phone: Contact

Aftercare Treatment Plan: NuWay or Other: 

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Why do you want sober living and sobriety? 

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