Sober Living of Washington Guest Contract
LEGAL Name of Sober Guest:Client first nameClient last name
Nickname, if applicable: Client nickname
Date of Birth: Date
Entry Date: Date
Location: Client facility
Sober Living of Washington Lodging Guest Agreement and House Code of Conduct and Rules.
This Agreement is between Sober Living of Washington and Guest at this location:
Checkboxes 1515 East 29th street, Vancouver, Washington 98663 (Men’s)
Checkboxes 1511 East 29th street, Vancouver, Washington 98663 (Men’s)
Checkboxes 2105 SE Talton AVE, Vancouver Washington 98683 (Men’s)
Checkboxes 9012 NE 89th Circle, Vancouver Washington 98662 (Women’s)
The signatures on this document indicate that the guest has read through and understands this agreement completely and will adhere to the terms herein or be exited from Sober Living of Washington properties willingly and without recourse. The guest has had an opportunity to review and ask any questions about the terms before signing.
Mission
Sober Living of Washington (SLoW) is focused on providing a safe, well-structured living environment as an effective transition program from active substance abuse into Recovery. We offer a place to feel human again, establish a disciplined life, and maintain a strong program of sobriety and recovery. While life experiences happen, we are here to provide the support we feel is necessary to sustain a sober existence and achieve your goals. Our vision is for you to use this space as a steppingstone for the road ahead in recovery. Our program is here for you- as long or as short as needed. We do not require minimum or maximum lengths of stay.
Sober Living of Washington (SLoW) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SLoW does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. SLoW also complies with applicable state laws and does not discriminate on the basis of creed, gender, gender expression or identity, sexual orientation, marital status, religion, honorably discharged veteran or military status, or the use of a trained dog guide or service animal by a person with a disability.
**COMPLETING THIS FORM DOES NOT GUARANTEE ACCEPTANCE INTO SOBER LIVING OF WASHINGTON**
SOBER LIVING OF WASHINGTON's MAIN APPROVAL CRITERIA IS THAT YOU ARE:
• Medically Stable (not in active detox, not in active medical emergency)
• Mental Health Stable (not in active psychosis, stable on medication, etc.)
• Able to pass a UA/ Breathalyzer upon arrival (THC positives are subject to discretion due to length of time detectable)
• No prior sex offenses ever convicted or; major violent offenders within the last year
SLoW Program Outlines:
● Blackout Phase- The first two weeks of your stay will be a blackout phase. You will be allowed to use personal electronics and phones- but leaving the house will be restricted unless supervised/ chaperoned by a senior house member, house manager, or staff member. We make accommodations during this phase for guests who are working (you may work your normal scheduled job with a schedule provided to house management) or if there are appointments for clinical services (such as IOP) or medical services that need to be attended that we cannot accommodate supervision for. It is very important that any travel for the first two weeks be communicated and approved by your house manager prior to leaving. Communication is key, we want to establish a relationship with you during the first two weeks. Leaving without permission will result in immediate termination of your stay with us. Initials Text field
● Phase one - First 30 days (including blackout) following your entry into the house. Any variance to this policy must be pre-approved by management prior to each instance occurring. Overnight stays away from the home are not allowed for the duration of phase one. During phase one your curfew will be 10pm on weekdays and 12am on weekends (weekends are Friday and Sat) Any guest not in compliance with phase one rules may experience an extension of phase one period, written violation, or termination of your stay with us Initials Text field
● Phase two – After the first 30 days, you are allowed to come and go as you please to take care of your daily duties. It is best if we know your work schedules or know where you are leaving to in case of emergency. In phase two the curfew extends to 11pm on weekdays, and 1am on weekends. Overnight stays are allowed, but overnight stays must be planned at least 7 days in advance and will require approval from house manager. Generally, an “extended overnight” or trip will be relegated to 3 nights, 4 days. Initials Text field
● SLoW has a zero-tolerance policy toward drug and alcohol use on or off the premises. Confirmed substance use will result in the Guest’s immediate dismissal from the house and you will have 1 hour to collect your belongings. We will provide you with local options for safe shelters to ensure to the best of our ability you are not left alone in the cold. We do have a re- entry process to get you back into our program if desired. All guests may be asked to submit to drug and alcohol test at any time. Refusal to submit to a test will be treated as a positive test result. We do test for Kratom and other “head shop” substances, use of these substances while you are enrolled in our program will result in termination of your stay with us. Please be aware of what you are putting in your body- medications with alcohol or other similar instances will be treated as a positive result, and our UA’s are very sensitive. Initials Text field
● Each guest is required to attend at least 5 recovery meetings (AA, CA, NA, Wellbriety, SMART, Refuge, Celebrate Recovery, etc.) per week. If a guest is not employed for an extended period of time, the guest will be required to attend 10 recovery meetings per week. Each guest must have a sponsor or recovery mentor, and a service commitment within 2 weeks of moving into the house. Attendance at the weekly SLoW- House meeting is also required. House meetings are unique to each house for time and day of the week. Please communicate with the house manager as to when the house meeting is. Missing the house meeting may result in termination of your stay. Initials Text field
● You are responsible for handling and taking your own medications, however during your stay with us you are required to keep your medications in a Locker space that will be provided to you. IT IS YOUR RESPONSIBILITY TO MANAGE YOUR MEDICATIONS. YOU MUST FOLLOW DOSING SCHEDULES AS PRESCRIBED BY YOUR DOCTOR. Sharing, stealing, or giving away prescription medications is grounds for immediate termination from your stay with us. Any medications a guest is taking should be kept strictly confidential. DO NOT discuss your medication dosing, schedules, or any other information with other SLoW guests. You agree that SLoW cannot be held responsible if you abuse your medications. House managers must be made aware of any changes to your medication. Random medication counts to ensure accountability and adherence to your medications will happen at any time, for any reason. If medications are changed without notification, this may result in termination of your stay. Initials Text field
● You will be expected to meet your daily obligations. Sleeping all day, watching TV and isolating will not be tolerated and can result in termination of your lodging. This recovery home is not “a place to stay” it is a place to GROW. Sober Living of Washington is purely a recovery home environment. We do not provide case management or counseling/ clinical/ or medical services. Our program does not include 24-hour supervision. We are happy to connect you with other resources to the best of our ability should you need assistance finding support or need additional clinical services. Initials Text field
● You will alert management immediately should you discover that another guest has relapsed or is using drugs or alcohol. If management discovers that you were aware of another guest’s relapse before or after, and you did not inform management when you discovered the relapse occurring, it is grounds for termination of your lodging. Initials Text field
● Illegal activity or illegal items are not tolerated at our recovery homes. Use of the dark web is prohibited. Anything that is a crime on the street is a crime in our homes- and will not be tolerated in our recovery homes and your contract will be terminated should any variety of these situations arise. Initials Text field
● Mental Health Crisis are not something that staff or house managers at SLoW can manage. If you are experiencing a mental health crisis or are being told by SLoW Staff or SLoW House Managers that you must enter mental health stabilization before being allowed back on Sober Living of Washington properties and refuse, your stay with us will be terminated. We are not a crisis stabilization program. By initialing below, you agree to enter mental health stabilization upon request from SLoW staff or SLoW House Management. Initials Text field
● Prohibited Items such as weapons of any type, ammunition or explosive items, drug or alcohol paraphernalia, offensive or drug/ gang related clothing items are not permitted on SLoW property or in personal vehicles for guests of SLoW property. Potential Inhalants such as air duster are not permitted. We do not allow “head shop” substances such as Kratom, CBD, Spyce, or any other type of substance that could have potential for abuse. Cold medicines with alcohol based ingredients are not permitted. Non-alcoholic drinks such as O’Doul’s or “Near- beers” are not permitted. Initials Text field
● Violence, and aggression in any form including damaging house property and/or using abusive language or threatening language will not be tolerated and may result in immediate termination of your lodging. The on-site manager and SLoW staff will mediate any disputes. Guests are not responsible for- or allowed to- confront another guest about behaviors, drug use, or issues within the recovery home. Only one warning is permitted before termination of your stay due to this behavior. Physical violence events are grounds for immediate termination of your stay based on house vote for who was the aggressing party. Initials Text field
● Cleanliness and good housekeeping by all guests will be expected at all times including beds made up in the morning, maintaining good personal hygiene and washing laundry and bed linens at least once a week. Excess body odors from not maintaining personal hygiene is not acceptable for a group environment and you will be given contract violations for excess odors. All spaces in the home are expected to be ready for new guest arrivals. If the bed next to yours is empty, no property of yours should be in that bed space. If a cabinet for food is empty, it should remain empty for the next guest to utilize. Initials Text field
● Chores will be assigned weekly on a rotating basis. Chores are expected to be completed according to the instructions outlined on the chore descriptions. Management will check chores when complete and if they are not done to the satisfaction of management, the guest will be asked to redo chore. If chores are repeatedly not completed, this may result in doing everyone’s chores the following week. If chores are still not completed, this may result in termination of your stay. Initials Text field
● Neighborhood expectations -Each guest is expected to participate in making this home the best neighbor in the area. Guests must be “good neighbors”. We must be considerate as well as friendly and responsive to a neighbor’s needs. Shouting and any excessive loud noise, swearing, where you park your cars, playing loud music in cars, smoking only in assigned area, etc., should be strictly minded. Any neighborhood complaints or negative interactions are mandatory to be reported to SLoW staff or house management. Initials Text field
● Consent is given to management to search your room and personal belongings if SLoW staff or house management deems this is necessary at any time, for any reason. Prohibited items will be taken at this point and a discussion about the prohibited items will follow, with a chance for you to get rid of the prohibited items or they will be disposed of appropriately. If a firearm is discovered, firearms will be safely locked away and not returned to the guest, but rather a law enforcement agency, family member or friend who will need to come pick up the firearm from the property. Drug or alcohol paraphernalia will not be returned and will be destroyed. Initials Text field
● You agree to respect house rules and other guests. If you believe another guest has made an unreasonable request related to your personal habits, bring the situation up with the on-site manager, not to the guest that is accused. If house management has made an unreasonable request, you are responsible to bring the situation up with ownership. Initials Text field
● There will be mutual sexual respect for all guests and visitors to this house. Sexual activity in the house will be grounds for immediate termination of lodging. Sexual interplay will not be tolerated in the house. Sneaking in opposite genders will result in termination of your stay with us. Pornography is strictly prohibited. Initials Text field
● You agree to adhere to stated curfews and “over-night” outing terms.) Calls need to be made before 7pm (on the day of) to request to stay out past listed curfews. Calls made after 7pm will not be approved and will result in a contract violation or termination of your stay with us. Initials Text field
● Damage to the property could result in billing for expenses due to negligence or intentional damage to property. Initials Text field
● Space Provided for guests are a 3 drawer dresser, space under the provided bed, and half of a closet. SLoW recommends to bring about 2 weeks worth of clothing. SLoW does not offer storage space in our program in garages, or additional spaces. We do not allow anyone to bring in furniture FOR ANY REASON, if extra storage is needed the guest must find an alternative. Refrigerators are shared between guests, for overall courtesy regarding space in cabinets and refrigerator space- please only bring 1 weeks worth of food at maximum at a time. Depending on how many guests are in the home, you may need to go to the grocery store twice per week to keep space for everyone.Initials Text field
● Dismissal or Termination in Lodging- if a guest of SLoW is asked to leave for breach of contract or leaves of their own accord- without a 2-week notice- and sobriety fee has been collected for that month, the Guest will NOT be refunded balance of sobriety fee. This includes 3rd party funding and family funding. If the guest has given proper two weeks’ notice and no contract violations have caused termination, the guest or responsible party will be paid the sobriety fee less an average of $20/night. Check will be issued for the remaining balance through SLoW accountant and may take up to 30 days for refund. Initials Text field
● Residual property – Any property left behind will be disposed of or donated after thirty days from the date of departure unless prior approval has been given by on-site management to store property for any longer duration. WE DO NOT PROVIDE STORAGE AT OUR PROPERTIES FOR ANY FAMILY, FRIENDS, OR SIGNIFICANT OTHERS. Terms and conditions on extended storage are on a case-by-case basis and must be discussed with on-site management prior to leaving the house. If you are in need of more time, communication must occur, and you will be given a timeline to collect the belongings. Mail received after discharge from SLoW will be "returned to sender", we will not hold mail for you after you have discharged. Initials Text field
You hereby recognize, understand, and agree that we can terminate your lodging for any reason we deem necessary. You are giving management total discretion to dictate whether you may continue to remain at the house or not as a guest not a tenant, and any reason management feels at their discretion is necessary for you to leave the house, you must obey their final decision on this matter. The fee you pay is a Sobriety Fee, not rent. Initials Text field
You are required to provide an emergency contact, should emergency situations arise.
Name: Text field
Phone: Text field
Probation or Parole/ DOC Contact (If applicable)
Name: Text field
Phone: Text field
Sobriety Fees of $750.00/month will be due the 1st of every month. This is for shared rooms, we do not offer single room space in our homes. This covers furniture, bedding, TV streaming services, internet, cleaning supplies, and toilet paper and paper towels. You are responsible for your food, toiletries, transportation, and any personal items. Fees due at the time of entry are $750 monthly fee plus $250 nonrefundable admin fee. ($1000 total). Your second month will be prorated if moved in on any other day than the first of the month.
Example: Billy A moved in on January 15th. On the 15th, Billy would pay $1000 to move in, followed by $375 in February (based on $25 average per day) and $750 from March moving forward until Billy moves out.
Total move in cost: $1000 Initials Initials Text field
Second month cost (for prorated purposes) $ Text field Initials Initials Text field
By signing below, you signify you have reviewed, understood, and will abide by this agreement, rules, code of conduct, and fees as defined.
Guest: Signature
SOBER LIVING OF WASHINGTON HIPAA Notice
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. This notice is effective as of October 31st, 2019.
Housing, payment, and non-health care operations:
Sober Living of Washington (hereinafter SLoW) uses and discloses your protected health information for housing, payment, and non-health care operations. Some examples of when our program may use or disclose your information for these purposes include:
Sharing test results with other health care providers for confirmation of a diagnosis;
Providing your diagnosis or other information about your health to third parties for payment assistance (if applicable).
Information requested by law enforcement (specifically probation or parole, not provided to law enforcement in any other circumstance unless a crime has been committed.)
Other uses and disclosures:
SLoW may also use or disclose your protected information, in compliance with guidelines outlined by law, for the following purposes:
Providing you with information related to your health;
Contacting you regarding appointments, information about treatment alternatives, or other health related services;
Incidental uses or disclosures (e.g., listing your name on a sign-in sheet, etc.);
Compliance with all laws (including reports of suspected abuse, neglect or violence);
Providing certain specified information to law enforcement or correctional institutions;
Providing information to a coroner, medical examiner, funeral director or organ procurement organization;
Public health activities when requested by a public health authority or the FDA.
Responding to health oversight agencies;
Responding to court or administrative tribunal orders, subpoenas, discovery requests or other lawful process;
When necessary to avert a serious threat to health or safety;
Military affairs, veterans affairs, national security, intelligence, Department of State, or presidential protective service activities;
Providing information to public or private disaster relief agencies; or Information to a family member, other relative, or close personal friend when: notification of your location, general condition or death; to assist in your health care (e.g. pick-up prescriptions or other documents, note follow-up care instructions, etc.)
Authorization for other uses: SLoW will make other uses and disclosure of your protected health information only after obtaining your written authorization. If you authorize a use not contained in this notice, you may revoke your authorization at any time, by notifying us in writing that you wish to revoke your authorization.
Your rights regarding the privacy of your health information:
Subject to limitations outlined by law, you have certain rights related to use and disclosure of your protected health information, including the right to:
Request restrictions on certain uses and disclosures. However, SLoW is not obligated to agree to requested restrictions;
Receive confidential communications or protected health information;
Inspect and copy your protected health information with some limited exceptions;
Amend your health information;
Receive an accounting of disclosures of your health information;
Obtain a copy of this notice.
SLoW duties regarding the privacy of your health information:
Subject to limitations outlined by law, SLoW has certain duties related to your protected health information, including:
SLoW is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
SLoW is required to abide by the terms of the privacy notice that is currently in effect.
SLoW reserves the right to change a privacy practice described in this notice and to make such change effective for all protected health information. Revised notice will be posted in our office and available upon request.
Concerns:
No individual will be retaliated against for filing a complaint.
Guest Signature: Signature
THIRD PARTY PAYMENTS AND FINANCIAL ASSISTANCE DISCLOSURE
At Sober living of Washington, we understand not all can afford sobriety fees. We will do our best to guide you to providers of funds for sobriety fees.
If you receive financial assistance from a third party, family, or entity unknown to SLoW, you are responsible for caretaking your financial aid. Payments will be made to Sober Living of Washington, if staff has agreed to this prior.
If your financial aid stops payment during your stay with us, you will be responsible for repayment for Sobriety fees.
If your stay with us is terminated or you leave without a two-week notice- your financial assistance entity may not receive a refund. If the entity is to receive a refund, this refund will NOT be refunded to you. In this situation, Refunds are allocated to the responsible party.
You will be notified when we receive payment from the responsible party on a monthly basis. If your fees are not paid for within 30 days by the responsible party, you will be responsible for payment for the second month and a payment plan will be discussed and put in place to continue your stay with us.
Guest Signature: Signature
Name of responsible party (or company): Text field
Contact information of responsible party: Text field
Staff Notes:Paragraph
Sober Living of Washington Legal Agreement
AGREEMENT BETWEEN Text field (“GUEST”) AND SOBER LIVING OF WASHINGTON, LLC WITH RESPECT TO SOBER LIVING ENVIRONMENT, POTENTIAL TRANSPORTING, AND CONCERNS OF CASE MANAGEMENT SERVICES PERFORMED FOR GUEST.
GUEST hereby releases SOBER LIVING OF WASHINGTON, LLC and any individual acting for SOBER LIVING OF WASHINGTON LLC from any and all claims, liabilities, damages, costs and expenses arising from the sober living environment, transport, and case management services to be performed hereunder, and GUEST shall also indemnify, defend, and hold harmless SOBER LIVING OF WASHINGTON LLC and any individual acting for SOBER LIVING OF WASHINGTON LLC against any and all claims, liabilities, damages, costs and expenses brought by any third party (Including OTHER GUESTS IN THE HOME) arising from or related to SOBER LIVING OF WASHINGTON LLC acts or omissions hereunder, unless determined by a court of competent jurisdiction to be caused by the willful misconduct or gross negligence of SOBER LIVING OF WASHINGTON LLC. GUEST agrees to refrain from deposing SOBER LIVING OF WASHINGTON LLC and company in legal matters involving third party civil claims.
GUEST acknowledges that the results of the sober living environment, transportation and case management provided hereunder are not guaranteed and are dependent upon the participation and cooperation of GUEST. In no event shall SOBER LIVING OF WASHINGTON LLC be liable for any incidental, indirect, special, or consequential damages, regardless of the form of action. SOBER LIVING OF WASHINGTON LLC aggregate liability under this agreement for any damages whatsoever shall not exceed the total amount paid by GUEST to consult hereunder.
During this term of agreement, SOBER LIVING OF WASHINGTON LLC may have access to and become acquainted with GUEST’s confidential information, meaning all nonpublic information in written, electronic, oral, and other tangible or intangible form concerning the GUEST, including information GUEST’s medical condition(s) and substance abuse, and other protected health information regarding GUEST’s medical condition and substance use disorder and other protected health information (“PHI”) as provided in the Health Insurance and Portability and Accountability Act of 1966 and its implementing regulations. GUEST acknowledges and agrees that SOBER LIVING OF WASHINGTON LLC may require access to such Confidential Information for the purpose of fulfilling its obligations under the agreement, and that SOBER LIVING OF WASHINGTON LLC may use and disclose PHI in connection with the performance of its services hereunder and to carry out SOBER LIVING OF WASHINGTON LLC legal responsibilities. Otherwise, SOBER LIVING OF WASHINGTON LLC will not use or further disclose Confidential Information (including PHI) except as permitted or required by this agreement or as required by law.
SOBER LIVING OF WASHINGTON LLC may not assign or transfer this agreement or any of its rights, or delegate or sub-contract out any of its duties under this agreement, without the prior written consent of the GUEST. This agreement contains the entire understanding of the parties, may not be amended except in writing signed by both parties, and shall be governed by the laws of the STATE OF WASHINGTON applicable to contracts to be performed entirely within such state. AGREED by the parties as of the Start Date on this contract.
GUEST SIGNATURE: Signature
Sober Living of Washington UA Policy
At Sober Living of Washington, we are fully focused on providing a safe and secure environment for our guests. As a part of this, we utilize drug and alcohol Urine Analysis (UA) screens to ensure the drug free environment of our program. Samples are to be provided under visual supervision from a staff member. We also perform Breathalyzer tests.
As a part of this UA screening, if there is a positive result or suspicion of abuse of medications- we may utilize a Laboratory to perform confirmatory testing of samples. However, if a UA comes back with a positive result that needs further confirmatory testing and you disagree or contest the results of the screen you will be responsible for the costs associated of confirmatory testing.
By signing below, you acknowledge and agree to:
Provide Urine Analysis samples under visual supervision from a SLoW staff member
Provide Urine Analysis samples within 1 hour when requested from SLoW Staff members
If a sample is not provided within 1 hour period, you will not be allowed to leave the group common area until a sample is provided
If you refuse to provide a sample, termination of your stay with us will be enforced and you will have two hours to leave the premises
If you have a positive result of a UA screen- you have the right to ask for a secondary test. If both tests are positive and you contest the results of the screen- you will be required to pay for the fees of confirmatory testing or you must leave the premises.
Guest Signature: Signature
Sober Living of Washington Food Policy
Sober living of Washington does not provide food items for the duration of your stay with us. We may have emergency options available for you if no funds are available during admission to our Recovery Home, but this is not guaranteed.
We can provide information for you to get enrolled in a state food stamp program and have contacts available to make that process easier.
During your stay with us, it is important to note that FOOD IS NOT ALLOWED IN LIVING QUARTERS. This means any food or drink other than water is NOT allowed in your room.
You will be given a designated area in the cabinets for your food storage, as well as a designated area in the fridge for your personal food items.
Please keep food purchases to a week’s worth of food at a time to save space for other guests in the home.
STEALING FOOD IS PROHIBITED AND MAY RESULT IN TERMINATION OF YOUR STAY WITH US. By signing below, you acknowledge and understand our food items policy:
Signature: Signature
SOBER LIVING OF WASHINGTON VEHICLE POLICY
If you have a vehicle, you may use your vehicle during your stay at Sober Living of Washington after management has approved. Driving of other guests must be approved by staff or house manager before a ride is given to another guest.
In order to use your vehicle and park in on our premises you must:
Provide a Valid Driver’s license, current insurance, and registration for the vehicle in your possession.
If you cancel your insurance during your stay or lose your license and we find that you have still been driving- this will result in termination of your stay at SLoW.
Have the vehicle in working order. We do not allow vehicles that are leaking fluids or are broken down to be parked in our spaces or in the neighborhood. This is for overall neighborhood cleanliness.
If your vehicle is visibly damaged (missing windows, bumpers, extreme damage, etc.) you will need to fix the vehicle or have a plan to fix the damage before bringing the vehicle on the property.
You may not park in the garages of SLoW properties; street parking is available. Please do not park in front of the mailbox or in front of the neighbor’s houses without prior permission given by neighbors.
Damage to your vehicle will be considered a risk you take, SLoW will not cover damage to your property for any reason.
Guest Signature: Signature
Guest Name: Text field
Driver’s License Number:Text field
Insurance CarrierText field
Policy Number: Text field
Customer Service Number: Text field
License Plate Number: Text field
Make: Text field
Model: Text field
Color: Text field
SOBER LIVING OF WASHINGTON VISITATION AND OVERNIGHT POLICY
Visitation:
At Sober Living of Washington, we are committed to providing a safe and secure environment for the guests that are enrolled in our program. For this purpose, we do not allow overnight stays, or visitation from spouses or family members inside the recovery home or on Sober Living of Washington property.
Family members, spouses, and other support people may see the inside of our recovery home and see the rooms during a scheduled tour times that are set up prior to entry with staff.
The only parties that are allowed to enter the property (including front and back yards of our homes) after entry into the program are Probation and Parole officers, lawyers that are associated with your case, and same sex 12-step/ recovery sponsors. We do not allow other visitors of any type in the front yards, back yards, or any part of our properties at any time. If friends or family are dropping items off for you, they are limited to a 10-minute stay in front of the property parked on the street. Hanging out in front of our homes with friends or family beyond 10 minutes is not allowed and will result in a contract violation. If someone enters the home without permission from SLoW staff or SLoW house management your stay with us will be IMMEDIATELY TERMINATED.
Please note that probation and parole officers are the only parties allowed to enter living quarters and are slowed to enter whether the guest is present or not. You must always allow DOC officers in the home, even if the applicable guest is not home. Sponsors (same-sex), recovery mentors, and lawyers must stay in the common areas for step-work purposes and other affairs. If personal step work or any confidential communication is needed, please leave the premises after approval from the acting house manager or staff (if applicable)
We do our best to provide notification of a probation or parole officer that is going to enter the living quarters so as to give you time to conceal family photos, or other private personal affects for your privacy. That being said, some probation or parole officers show up on surprise visits- this means we cannot give heads up on every occasion.
Overnights: After phase one, you are eligible for overnight stays upon approval from staff and house management. Overnight stays are limited to a maximum of two per month unless there are extenuating circumstances such as court proceedings, family events, etc.
You must obtain approval for overnight stays a minimum of 5 days prior to the overnight stay. Please acknowledge that we will ask who you are staying with, the reason you are staying there, and for a recovery plan in the case of emergencies. NOT ALL OVERNIGHT PASSES WILL BE APPROVED. THERE MAY NOT BE A GIVEN EXPLANATION OF WHY YOUR PASS WAS NOT APPROVED. Trips and extended overnight stays are relegated to 3 nights, 4 days. Upon arrival back from overnight pass you will be required to submit a UA/ breathalyzer when requested. By signing below, you understand and acknowledge the above-mentioned policies and procedures regarding visitation and overnight passes.
Signature: Signature
Common Area Usage Policy
To support having normal hours for sleeping, eating, resting, and entertainment- as well as common decency for other guests in the house- the common areas will have restricted time use. There may be exceptions made for guests because of their work schedules, but these exceptions will be reviewed by management and need to be preapproved.
**If all guests in the home are awake and participating in the entertainment, this policy would not apply. For respect of the neighborhood- all guests should be in their rooms before 2am. **
The restricted time period is from 12AM (midnight) thru 6AM every day. Common areas that are not permitted during this time period are:
Living Room areas and the usage of any electronics in that area.
The Kitchen and eating area
Backyard, Decks, or front yard areas
Computer areas or any other common areas.
Cooking meals past 12am.
If your roommate is complaining of you being up past midnight and disturbing their sleep due to use of electronics, you will be given a contract violation. If you continue the behavior without regard for your roommate, your stay will be terminated with us.
Guest Signature: Signature
BORROWING ITEMS, LENDING MONEY, GIVING MONEY
This agreement is between Text field and Sober Living of Washington.
During your stay at Sober Living of Washington, it is a requirement that no money or currency is exchanged, or debts incurred with any guests, house management, or staff (other than staff regarding sobriety fees). We understand that everyone comes in with different situations, however doing this causes unnecessary tension and can lead to negative experiences in the program.
We ask that you NEVER lend money or give anyone money or items in exchange for money. Similarly, trading or bartering, or gifting items is not allowed. If a guest or manager is proposing this and making you uncomfortable, please reach out to SLoW with this issue so it can be resolved immediately.
Guest agrees during their stay at Sober Living of Washington:
I will not borrow money from any other guest at SLoW
I will not lend money to any guest, manager, or staff at SLoW
I will not exchange gifts or items for money
I will not trade food stamps or any other forms of currency for money or items.
It is strongly encouraged not to let any guest borrow personal items
It is permitted and ENCOURAGED to pay another guest gas money for rides if you are utilizing their transport. Each guest and manager have the right to decline rides or ride sharing at any time, for any reason. You are responsible for your own travel needs, please plan accordingly.
Breaking this contract will result in a contract violation (maximum of 3)
Guest: Signature
Sober Living of Washington ACCEPTABLE USE POLICY- WEB BASED ACTIVITY AND ELECTRONIC USE STATEMENT:
This policy applies to the use of information, electronic and computing devices, and network resources to conduct Sober Living of Washington business or interact with internal networks and business systems, whether owned or leased by Sober Living of Washington, the employee, a guest, or a third party. All employees, guests, contractors, consultants, temporary, and others at Sober Living of Washington and its subsidiaries are responsible for exercising good judgment regarding appropriate use of information, electronic devices, and network resources in accordance with Sober Living of Washington policies and standards, and local laws and regulations.
1.1 Unacceptable Use
The following activities are, in general, prohibited. Employees may be exempted from these restrictions during their legitimate job responsibilities (e.g., systems administration staff may have a need to disable the network access of a host if that host is disrupting production services).
Under no circumstances is an employee or guest of Sober Living of Washington authorized to engage in any activity that is illegal under local, state, federal or international law while utilizing Sober Living of Washington-owned resources or personal resources.
The lists below are by no means exhaustive but attempts to provide a framework for activities which fall into the category of unacceptable use.
1.1.1 Unacceptable System and Network Activities
The following activities are strictly prohibited, with no exceptions:
Violations of the rights of any person or company protected by copyright, trade secret, patent or other intellectual property, or similar laws or regulations, including, but not limited to, the installation or distribution of "pirated" or other software products that are not appropriately licensed for use by Sober Living of Washington.
Unauthorized copying of copyrighted material including, but not limited to, digitization and distribution of photographs from magazines, books or other copyrighted sources, copyrighted music, copyrighted movies or TV shows, and the installation of any copyrighted software for which Sober Living of Washington or the end user does not have an active license is strictly prohibited.
Exporting software, technical information, encryption software or technology, in violation of international or regional export control laws, is illegal. The appropriate management should be consulted prior to export of any material that is in question.
Introduction of malicious programs into the network or server (e.g., viruses, worms, Trojan horses, e-mail bombs, etc.).
Revealing your account password to others or allowing use of your account by others. This includes family and other household members when work is being done at home.
Using a Sober Living of Washington computing asset or a personal computing asset to actively engage in procuring or transmitting material that is in violation of sexual harassment or hostile workplace laws in the user's local jurisdiction.
Making fraudulent offers of products, items, or services originating from any Sober Living of Washington location or account.
Effecting security breaches or disruptions of network communication. Security breaches include, but are not limited to, accessing data of which the employee or guest is not an intended recipient or logging into a server or account that the employee is not expressly authorized to access, unless these duties are within the scope of regular duties. For purposes of this section, "disruption" includes, but is not limited to, network sniffing, pinged floods, packet spoofing, denial of service, and forged routing information for malicious purposes.
Port scanning or security scanning is expressly prohibited unless prior notification to Infosec is made.
Executing any form of network monitoring which will intercept data not intended for the employee's or guest’s host, unless this activity is a part of the employee's normal job/duty.
Circumventing user authentication or security of any host, network or account.
Introducing honeypots, honeynets, or similar technology on the Sober Living of Washington network.
Interfering with or denying service to any user other than the employee's or guest’s host (for example, denial of service attack).
Providing information about, or lists of, Sober Living of Washington employees or guests to parties outside Sober Living of Washington.
1.1.2 Email and Communication Activities
Sending unsolicited email messages, including the sending of "junk mail" or other advertising material to individuals who did not specifically request such material (email spam).
Any form of harassment via email, telephone or paging, whether through language, frequency, or size of messages.
Unauthorized use, or forging, of email header information.
Solicitation of email for any other email address, other than that of the poster's account, with the intent to harass or to collect replies.
Creating or forwarding "chain letters", "Ponzi" or other "pyramid" schemes of any type.
Use of unsolicited email originating from within Sober Living of Washington's networks of other Internet/Intranet/Extranet service providers on behalf of, or to advertise, any service hosted by Sober Living of Washington or connected via Sober Living of Washington's network.
Posting the same or similar non-business-related messages to large numbers of Usenet newsgroups (newsgroup spam).
1.1.3 Blogging/commenting and Social Media
Blogging/commenting by employees and guests, whether using SLoW’s property and systems or personal computer systems, is also subject to the terms and restrictions set forth in this Policy. Limited and occasional use of Sober Living of Washington’s systems to engage in blogging/commenting is acceptable, provided that it is done in a professional and responsible manner, does not otherwise violate Sober Living of Washington’s policy, is not detrimental to Sober Living of Washington’s best interests, and does not interfere with an employee's regular work duties or a guest’s recovery. Blogging/commenting from Sober Living of Washington’s systems is also subject to monitoring.
Sober Living of Washington’s Confidential Information policy also applies to blogging/commenting. As such, Employees are prohibited from revealing any Sober Living of Washington confidential or proprietary information, trade secrets or any other material covered by Sober Living of Washington’s Confidential Information policy when engaged in blogging/commenting.
For privacy of all, Guests shall NEVER post social media photos, blogging, or posts including other sober living of Washington guests or staff without express permission from the parties photographed or video recorded. No photos of staff, photos or videos of Sober Living of Washington properties may be posted without consent of guests or staff of Sober Living of Washington.
Employees shall not engage in any blogging/commenting that may harm or tarnish the image, reputation and/or goodwill of Sober Living of Washington and/or any of its employees or guests. Employees and guests are also prohibited from making any discriminatory, disparaging, defamatory or harassing comments when blogging/commenting or otherwise engaging in any conduct prohibited by Sober Living of Washington’s Non-Discrimination and Anti-Harassment policy.
Employees and guests may also not attribute personal statements, opinions or beliefs to Sober Living of Washington when engaged in blogging/commenting. If an employee is expressing his or her beliefs and/or opinions in blogs, the employee may not, expressly or implicitly, represent themselves as an employee or representative of Sober Living of Washington. Employees and guests assume any and all risk associated with blogging/commenting.
In addition to following all laws pertaining to the handling and disclosure of copyrighted or export-controlled materials, Sober Living of Washington’s trademarks, logos and any other Sober Living of Washington intellectual property may also not be used in connection with any blogging/commenting activity
2. Policy Compliance
2.1 Compliance Measurement
The Infosec team and Sober Living of Washington will independently verify compliance to this
policy through various methods, including but not limited to, business tool reports, internal and external audits, and feedback to the policy owner.
2.2 Exceptions
Any exception to the policy must be approved by the Infosec team in advance.
2.3 Non-Compliance
An employee or guest found to have violated this policy may be subject to disciplinary action, up to and including termination of employment or your stay with Sober Living of Washington.
Guest Signature: Signature
CONTRACT VIOLATION PROCESS
If any policy in this contract has been violated or broken, you may be given a contract violation.
Definition: A written notification of the violation, with a behavioral warning and be allowed to remain at SLoW under a behavioral contract that the agreement will not be violated again **Guests will be given a maximum of 2 behavioral contracts before termination ensues**
Or; A termination of your stay at Sober Living of Washington may happen depending on the context of the situation deemed by House management/ SLoW Staff.
Upon termination: Staff or house management will notify the guest that their stay with us is terminated under the contract agreement and staff will allow 1 hour maximum for the guest to collect their belongings. If requested, a referral will be provided to local/ and or national resources to continue their recovery journey and we will support their transition to any program they choose. Re-entry to our program is encouraged should you decide you want to return and upon consideration from SLoW staff and house management.
Some helpful reminders in addition to contract items:
Once two weeks are reached during your stay with us you will be given a maximum of one warning to get a sponsor within a week or you will receive a contract violation. Not working a recovery program or showing some form of work with a sponsor/ Recovery mentor will be grounds for a warning and you will have 1 week to get proof of work with such, or we will issue a contract violation every week thereafter until termination.
Not going to enough meetings (or forgetting your slip) will result in an extra required meeting the following week. For example- If your requirement is 5 meetings you will need to attend 6 the following week. If required meetings have not been met the following week, we will issue a contract violation.
Not doing your assigned chore or not completing your chore up to house management standards may result in a
contract violation. Continuation of not doing chores or not doing chores up to standard will result in termination
of your stay with us.
Upon termination of your stay at SLoW:
*Family members/ Emergency contacts will be notified of the discharge for safety purposes
*Referral sources in which the guests originally came from will be notified for recovery accountability
*If a Probation/ Parole Officer is involved, they will be notified for Legal purposes
By Signing below, you agree you have read and understand our contract violation and termination policy. SLoW reserves the right to exit you from our properties at any time, for any reason.
Guest Signature: Signature
Grievance and Complaint Policy
During your stay at SLoW, there may be a time where you feel you have been treated unfairly, unproperly disciplined, or any other circumstance where escalation to communication with staff may be necessary.
Grievances and complaints are taken seriously. To submit a grievance- please follow these protocols:
For grievance against another guest:
- Communicate with the house manager about the guest, not to the guest directly.
- Follow the house managers instructions in the matter, do not bring complaints to another guest in the house.
For grievance against house management:
- Try your best to communicate with the house manager to resolve the issue, do not bring the issue to another guest in the house.
- Call, text, or email housing director (Billy Anderson) to discuss the matter.
- Call, text or email CEO (Tom Barella) to discuss the matter.
For grievance against SLoW:
- Try your best to communicate with SLoW staff and ownership to resolve the matter
- If you feel necessary, submit the complaint to WAQRR (Washington Alliance for Quality Recovery Residences) at 253-293-5208 or any state agency that you feel will address your concern.
Guest: Signature
Maintenance items and home repairs/ Employment of Repair Workers
During your stay at Sober Living of Washington, it is extremely important to us that our homes are presentable, safe, calm, and clean at all times.
Our goal is to provide you a place to get back on your feet and start your road to recovery. If there are issues at the home such as broken items, broken appliances, issues with furniture or any other concerns in the home- it is imperative that staff is made aware of the issues. If you have maintenance issues in the home- please let management know so we can perform the necessary repairs in a timely manner. Not all items will be fixed same day, but it is our goal that our homes are in operating order at all times.
Should a guest have experience in repairs and wants to repair the issue- Staff must be made aware and agree to pay schedule and timeline. Paid work for repairs done is considered completely voluntary. No Guest will be given consequences for declining paid work. Guests who accept paid work are not treated differently than those that do not. All qualified guests are given equal opportunity for available work. Wages are determined by marketplace value. Unsatisfactory work done is not cause for termination of your stay with us.
By signing below, guest agrees to alert management to any issues in relation to SLoW property and paid work guidelines:
Guest: Signature
SLoW High-Risk Waiver
Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS) / Tuberculosis (TB) / Hepatitis C: This is to inform you, the guest, that those with substance abuse addiction often participate in High-Risk Behaviors that lead to the spread of diseases such as Hepatitis C, TB and HIV/AIDS. In the effort to keep all of the guests safe from these diseases we ask that you make the following agreements and acknowledgments:
a. High-Risk Behaviors are defined but not necessarily limited to sexual contact of any kind, needle use and needle sharing, and physical contact that may exchange any bodily fluids.
b. Not engaging in High-Risk Behaviors while in SLoW will eliminate the possibility of contracting any blood-borne diseases.
c. While in SLoW you will not engage in any sexual contact with a fellow participant nor initiate an intimate physical relationship with a fellow participant. Doing so may risk your health and further participation in our program.
II. HIV / AIDS, Hepatitis C Education: These diseases are NOT spread by casual contact.
III. Confidentiality: Every guest is entitled to confidentiality about themselves and any medical condition they may have, what medications they may be taking and any illnesses they may think they have. Any and all information shared privately or in groups must follow strict confidentiality guidelines for you or whoever chooses to share such confidential medical or personal information.
*Should there be any Bodily fluid discharge by a guest in the house (blood on the wall or floors, etc.) The guest responsible for the fluid would be the one responsible for cleaning.
Bodily fluids should be cleaned with a 50/50 Bleach and water solution for sanitizing purposes. Spray on bleach solution, allow it to sit for 1 minute before wiping.
*Should the guest responsible not be available to clean, it is highly recommended that the guest cleaning the fluids use rubber cleaning gloves and eye protection. Use paper towels for cleaning fluids, not cotton towels.
*If guests are uncomfortable cleaning, please notify management immediately so it can be taken care of. All guests should stay clear of the area exposed until the cleaning has elapsed.
Guest Signature: Signature
A HELPFUL NOTE TO REMEMBER:
You need to be completely aware of the type of living situation you're about to enter. We are a transitional shared living space. The type of people that enter this house often have just been released from Treatment programs, jail or institutions, detox programs, may have a mental health diagnosis, and most are in the beginning stages of recovery from addiction/alcoholism.
Often times our house guests exhibit all of these traits. Before you think someone should behave in a particular way or exhibit particular ways of expressing respect, please be aware that your view on this subject will differ from others.
We do not have 24-hour supervision, we do not have accessible staff or peer leaders at all times of the day. We are purely a sober living environment with peer-led and community reinforcement. We are not a house for all, but we strive to be a place where those that are willing to work at their issues and follow our guidelines will be safe and supported in the journey of repairing their lives.
We are a place to show support and grow. This means showing a base level of compassion towards other house members who are dealing with their own struggles. If there is truly a concern, please take it confidentially to the manager of the house or staff. We aim to create an environment where everyone can thrive, this takes a collective effort to support everyone.
GUEST SIGNATURE: Signature
PERSONAL PROPERTY RISK WAIVER
Sober living of Washington does not assume responsibility for personal belongings, vehicles, valuables, or anything that you bring on SLoW property.
We have had very little instances of petty theft in our program, and very few property crimes at our sober living homes. However, what you bring on SLoW property is brought at your own risk. If there is a crime that happens to your property outside of the home, please report this to your house manager and SLoW staff, as well as report this to Police. Hopefully our cameras will have caught footage, but this is not guaranteed.
If there is theft of your property inside the home and another guest is suspected of this theft, please report this to house management and/or SLoW staff. SLoW staff will determine if police involvement is necessary. SLoW does not take financial responsibility if your property in the home is stolen by another guest. Again, this has happened very few times since our opening in 2019 but SLoW wants you to use caution to bring in highly valuable items. We do provide a small locker for valuables (med lockers), only you and the house manager have a key to that locker.
By signing below, you agree to hold harmless Sober Living of Washington for any theft that occurs:
Signature
Sober Living Weekly Meeting Agenda
Thank you for coming to the SLoW house meeting. We are here to discuss how things are going with recovery responsibilities and to keep each other accountable. We are NOT here to bring each other down or chastise any guest for missed obligations. Ground rules are: No yelling, no pointing fingers, keep this calm and supportive for all of us. REMEMBER: We are all new to recovery and will make mistakes- we are a community and all of us can do this together with support from each other.
Chores: Assignment, missed chores, supplies needed for chores to be completed, guest concerns with chore responsibilities
Recovery Meetings: Guests turn in weekly meeting slips to confirm meetings attended. Any meetings missed by guests are to be brought up for accountability
Sponsorship: Open forum for guests to talk about step work, community discussion on questions with sponsorship in a general way. Discuss what step each guest is on. No great detail is needed but this is to keep recovery progress or step work in the forefront of our minds each week.
Job Opportunities/ Volunteer: Each guest discusses job opportunities they have found- if they are working give the guest time to speak about their job and how it is going.
General Concerns: Clients can voice concerns if they need something to support their recovery. (e.g., Bus passes, health care, doctor appointments, legal appointments, etc.) provide community support to help them achieve their necessities if reasonable. Issues with properties, issues within the home.
Weekly Goals: Each guest gives one goal they hope to accomplish for this week.
SOBER LIVING OF WASHINGTON CHORE DESCRIPTIONS:
At Sober Living of Washington, we ask that in some scenarios you use your judgement on chores and what needs to be done to keep this a clean and safe environment. These descriptions are a general idea of what we are looking for in each specific chore- but if there are circumstances that may require a little more effort to be put in for the good of the household, please complete the task.
ANY QUESTIONS OR CONCERNS CAN BE BROUGHT UP AT HOUSE MEETINGS ABOUT CHORE DUTIES
DISHES: We do not expect you to wash the dishes of the other guests at SLoW. For this chore, please put in detergent and run the dishwasher when full. Dry and put away the dishes where they go. Clean the bottom of the sink(s) and around the sink area to keep it clean. Guests are required to wash the dishes they use and load them into the dishwasher. You may need to reorganize the dishes to make sure they are cleaned properly in the dishwasher.
FLOORS: Please use vacuum, sweep or use mop/ Swiffer cleaner to clean the floors. Make sure to get under beds and under dressers to the best of your ability. Make sure to get under couch cushions and behind couches at least once per month.
BATHROOMS: Clean toilet (inside and around the base), wipe off counter and inside sink, use mop on the floor. Please make sure to clean behind and around the toilet on the floor. Spray down the inside of tub/ shower with a cleaner and rinse with water. Scrub tub floor if needed.
COUNTERS AND SURFACE DUSTING: Dust and wipe down counter spaces on the main dining table, kitchen counters and coffee tables. Dust and wipe down all windowsills. Clean windowsills and baseboards.
SMOKING AREA/ OUTDOORS: Clean out cigarette butt holders and pick up any loose trash and cigarette butts. Wipe down the outside table(s). Spray outside areas with a hose to keep clean. Walk around the property and clean any trash or debris in front of house or side of house.
TRASH/ YARD: Take out trash in the home and put out trash bins for pick up (1 day before trash day) Pick up all trash in the yard or around the curbs. Pull weeds, mow and edge lawns. Keep our sober living one of the best-looking houses in the neighborhood!
FRIDGE/ CABINETS: Once a month we will have a whole house cleanout of cabinets and fridge shelves to keep them clean and throw away spoiled items. Pull out your items from the fridge and wipe down your area with a cleaner. Pull out your items from shelves, wipe up messes and crumbs. Keep empty areas clean for the next guest to enter.
DEEP CLEANING: It will be requested at least monthly for all guests to participate in a deep clean. This includes cleaning the floor baseboards, windows, cleaning out fridges and food storage areas.
SOBER LIVING OF WASHINGTON Consent For Release of Confidential Information
I, Text field
born on Date authorize Sober Living of Washington to release my confidential information electronically, orally, Written
to:
(NAME AND NUMBER)
Paragraph
Release is subject to:
Checkboxes Presence in Program
Checkboxes Lab UA/ UA Results
Checkboxes Discharge
Checkboxes Current Medical Status
Checkboxes Legal Status
Other: Text field
Reason for release of information:
(Medical information/ Medications )
Continuity of care - Guest history – Clinical or legal request Emergency contact - General Updates/ Presence in program.
Court services - Legal purposes – Probation/ Parole - Employment continuity
I understand that my records are protected under Federal Confidentiality regulations (42 CFR Part 2) published August 10, 1987, and the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191), 42 U.S.C. Section 1320d, et. Seq and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I understand that my medical record may contain information concerning my psychiatric, psychological, drug or alcohol abuse, HIV/Acquired Immune Deficiency Syndrome (AIDS) and/or related conditions.
I understand that I may revoke this authorization at any time upon written notice to Sober Living of Washington. I acknowledge that such revocation will not be effective if Sober Living of Washington has already acted in reliance upon this authorization.
This authorization is valid (if not previously revoked) this consent will terminate upon 365 days from the date of signature of this form, upon termination of services except for billing purposes only. This information has been disclosed from records protected by Federal Confidentiality rules (42 CFR part 2). The Federal rules prohibit making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR part 2. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse client.
Guest Signature: Signature
SOBER LIVING OF WASHINGTON DEMOGRAPHIC INFO
Washington Alliance of Quality Recovery Residences (WAQRR) sends out survey reports every month to Sober Living of Washington that we are required to fill out. For these purposes, WAQRR asks the following demographic information:
Client Name: Text field
Date of Birth: Date
Identified Race: Client race
Identified Ethnicity: Client ethnicity
Identified Gender: Client gender