Visitor Request Form

Visitation Hours
Days: Saturday & Sunday only
Time: 12:00 PM – 5:00 PM
No visitors are allowed outside of these designated times.

Visitor Requirements

  • All visitors must be requested and approved at least 48 hours in advance.
  • Visitors must arrive sober and free of all federally illegal substances and alcohol.
  • Visitors must present their full legal first and last name at the time of request.
  • Visitors must remain in designated common areas only.
  • 🚫 No visitor is permitted in any resident’s bedroom — including the room of the resident they are visiting.
  • Romantic partners are not permitted on the property at any time.

Resident Responsibilities
The resident is fully responsible for the conduct and sobriety of their visitor.
Visitors must sign in and out at the beginning and end of the visit and may be required to present a valid photo ID.
The resident must remain on the property for the entire duration of the visit.
If a resident lies about the identity of a visitor or their sobriety status, this is grounds for immediate discharge from the home.

House Safety & Authority
The House Manager or designated staff has the right to deny or terminate any visit at any time if:

  • The visit is deemed unsafe.
  • The visitor appears to be under the influence.
  • The visit disrupts the sober living environment.
  • The visitor engages in behavior not conducive to recovery.
  • Visitors violating the rules will be asked to leave immediately.

 

Consequences for Violations
Allowing a visitor into any resident’s bedroom is a serious violation and may result in immediate removal of the resident from the program.
Any visitor found under the influence of alcohol or federally illegal substances will be banned from future visitation.
Any resident violating this policy — including lying about a visitor’s identity or sobriety — will be subject to immediate discharge from New Vine Living.

Client first nameClient middle nameClient last name , agree to all rules listed in this request form and understand the consequences of violating any terms.

Date of visitation Date Time of visitation Text field

At what time will the visitation end? Text field

Name(s) of visitor

Paragraph

Signature of Resident

Signature

Date of signature

Date