Resident Information
Fair Housing & Non-Discrimination Disclosure
Rekindle Recovery Homes (RRH) operates in compliance with the Federal Fair Housing Act and the Texas Fair Housing Act. RRH does not discriminate based on race, color, religion, sex, national origin, disability, familial status, sexual orientation, gender identity, or any other protected class recognized by law. RRH provides structured sober living designed to support individuals in maintaining sobriety and building life skills necessary for long-term independence.
Resident Signature:
Signature
Date: Date
RRH Staff: Text field
Date: Date
Background Check Authorization
I authorize Rekindle Recovery Homes to conduct background screening for the purpose of evaluating residency eligibility and maintaining a safe recovery environment.
Full Legal Name:
Text field
Date of Birth: Date
Signature:
Signature
Date: Date
Drug & Alcohol Testing Consent
Residents may be required to submit to random or scheduled drug and alcohol testing to maintain a safe and sober living environment. Refusal to test may result in discharge.
Resident Signature:
Signature
Date: Date
Medication Disclosure Form
Residents must disclose all prescribed medications to RRH staff to ensure safety within the sober living environment. If any changes occur to the below medications or schedules, please let the HM or ED know immediately. Medications will be dispensed at the recommended schedules and dosages of the prescribing Dr.
Medication
Resident Signature:
Signature
Date: Date
Release of Information Authorization
I authorize Rekindle Recovery Homes to communicate with the following individuals or organizations regarding my participation in recovery housing.
Contact
Resident Signature:
Signature
Date: Date
Relapse & Re-Entry Agreement
If a relapse occurs, the resident agrees to notify RRH staff immediately. RRH may require detox, treatment, or additional recovery support before considering re-entry into the home.
Resident Signature:
Signature
Date: Date
Referral Source Information
Resident Belongings Inventory
This form documents personal belongings brought into the home at move-in to ensure clarity and accountability for both the resident and Rekindle Recovery Homes.
Inventroy
Resident Signature:
Signature
Date: Date
RRH Staff:
Text field
Date: Date
Move-In Property Inspection Form
This checklist documents the condition of the property and assigned room at the time of the resident's move-in.
Move-In Condition
Resident Signature:
Signature
Date: Date
RRH Staff:
Text field
Date: Date
Financial Responsibility Agreement
Residents are responsible for paying monthly program fees on time which is the first of the month. Fees contribute to housing, utilities, recovery programming, and household supplies. After the 5th day of the month, if full payment is not received, $20 per day later fee will be assessed.
Resident Signature:
Signature
Date: Date
This Resident Program Participation Agreement (“Agreement”) is entered into by and between Rekindle Recovery Homes (RRH) and the undersigned Resident.
1. PROGRAM OVERVIEW
RRH provides structured sober living and recovery support housing. Residency is contingent upon active participation in the program and adherence to all house rules.
2. TERM
This Agreement is a month-to-month license to occupy and may be terminated at any time by RRH for non-compliance. 7 days notice is requested if you intend to leave.
3. PROGRAM FEES
Monthly Program Fee: $1,250
Intake/Admin Fee: $250 or $500(with pet) (non-refundable)
All fees are non-refundable, including in cases of early departure, dismissal, or voluntary withdrawal.
4. NO LANDLORD-TENANT RELATIONSHIP
This Agreement does not create a landlord-tenant relationship. Resident is granted a revocable license to occupy the premises contingent upon compliance with program requirements.
5. RESIDENT RESPONSIBILITIES
Resident agrees to:
- Maintain sobriety
- Attend required recovery meetings
- Comply with curfew and house rules
- Participate in drug/alcohol testing
- Maintain respectful behavior
6. HOUSE RULES
Resident agrees to abide by all RRH House Rules, incorporated herein by reference. Violation may result in immediate termination.
7. DRUG & ALCOHOL POLICY
Any use of drugs or alcohol may result in immediate dismissal from the program.
8. TERMINATION
RRH reserves the right to terminate this Agreement immediately for:
- Substance use
- Non-payment
- Threatening or unsafe behavior
- Failure to comply with program requirements
9. ACKNOWLEDGMENT
Resident acknowledges understanding of all terms, including no refunds and immediate termination policies.
Resident Name:
Text field
Signature:
Signature
Date: Date
RRH Representative:
Text field
Date: Date
Print
Weekly Therapy & Recovery Participation Tracker-required to submit every week by Sunday evening to the HM
Weekly Therapy
Resident Commitment & Goal Setting Form
1. My Commitment to Sobriety
What does sobriety mean to you right now?
Paragraph
Top 3 sobriety goals:
1. Text field
2. Text field
3. Text field
Recovery program(s):
Text field
Sponsor Name (if applicable):
Text field
2. Personal Growth Goals
2. Personal Growth Goals
Personal goals:
1. Text field
2. Text field
3. Text field
3. Professional & Financial Goals
Professional Goals
4. Structure & Accountability
Accountability
6. My Commitment
I commit to actively participating in my recovery, respecting house rules, and working toward the goals outlined above.
Resident Signature:
Signature
Date: Date