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 other mood
altering prescription medications.
Name: Resident first nameResident last name
Age: Text field
Phone to reach you now: Resident phone
Phone to reach you upon release:Text field
Treatment Center: Treatment center 1 name
Counselor Name: Contact 1 name
Conselor Phone: Contact 1 phone
Aftercare Treatment Plan: NuWay or Other:
Why do you want sober living and sobriety?