7 - *Overnight Request Form REQUIRED FOR ALL OVERNIGHTS!!

Name - Client first name Client last name

Today's Date:  Date

Overnight stays need to be approved by the House Leader/Asst Leader at least 24 hours in advance.  You must be in compliance with all the house rules before approved and you must have been in the home for at least a minimum of 14 days.  My initials here confirm that I've gotten approval for this overnight.  Initials Text field

If you are self-pay or scholarship from a private IOP, no extra fees are due.      

If you are with a County funded IOP, you will need to pay Empowering Potential Housing $30 per night for your missing nights (discounted nightly rate to try and help you the resident).  Most programs - even HOSPITAL overnights need to by paid by the resident - sorry County of San Diego rules - not  EPH. 

We prefer Zelle or Venmo to empoweringpotentialhousing@gmai.com.  If you need help paying, please call Rachel at 619-500-3987 to make arrangements.

Missing Night(s):

Date

Date

Date

Date