Applicaiton

ODAT Recovery Homes Inc.

Mission Statement:  Offering the hope needed to pass through the Triumphal Arch a Free Man.

 

This agreement is between, Client first nameClient last name___ (resident/client) and manager; and/or owners of ODAT Recovery Homes Inc.  Resident agrees to voluntarily participate and reside in the recovery environment/home at 106 Creekside Ct, Gallatin TN 37066

This agreement is a recommended 6-month term effective_Date_______ to _Date_______. This agreement may be renewed or amended if agreed on and approved by management and owners of ODAT Recovery Homes Inc.

 

I agree and understand that residence at ODAT Recovery Homes Inc is pursuant to Tennessee Code Annotated 66-28-102 (c)(1), which states residence at an institution, public or private if incidental to detention or the provision of medical, geriatric, educational, counseling, religious, or similar service is not subject to the provisions of the Uniform Residential Landlord and Tenant Act of Tennessee. In other words, this agreement is not a lease, and notice is not required by ODAT Recovery Homes Inc to discharge a Resident for violation of institution guidelines.

Resident Signature: _Signature_______       Date: __Date_________

 

Personal Information:

      Date:_Date_________________   Name:Client first nameClient last name_______________________________________________________

      Prior Address:Client Address________________________________________________________________________

       Phone:_Client phone_______________________________E-mail:_Client email_______________________________________       

      DOB:_Client birthdate____________________________  DOC:_Client facility____________________________________________

      Marital Status:_Client marital status_______________________ Spouse Name:_Text field____________________________________

      Emergency Contact Name:_Family Members_______________________ Emergency Contact Phone:_Text field________________

     Relationship:_Text field_______________________________

     I_Client first nameClient last name_______________________ give ODAT Recovery Homes Inc permission and consent to contact my emergency contact, in case of                 emergency.

    Date of Arrival:_Date_______________________________________

    Are you currently on probation or parole? (Checkboxes Yes Checkboxes No)

    Probation Officer Name:_Probation_______________________________PO Phone #:_Text field_____________________

    I _Client first nameClient last name___________________give consent to ODAT Recovery Homes Inc to contact and to be contacted by my probation officer.

    Do you have any outstanding warrants and/or any pending charges? If yes, explain:

    Resident Signature: Signature________________________    Date: _Date__________

 

 

ODAT Recovery Homes Inc
                                              

Financial Transparency Agreement                                                               

Client Name:  Client first nameClient last name                                                     Date:  Date

Due at entry into ODAT Recovery Homes Inc.  The first week’s payment and entry fee ($225/week and application fee $300) for a total of $525 must be paid before resident moves in, and the continued $225 per week will be due thereafter.

Initial: Initials Text field        I understand that I will be responsible to pay $225 per week for the duration of my stay at ODAT Recovery Homes Inc.

Absolutely NO REFUNDS will be given if a resident leaves ODAT Recovery Homes Inc.

 Initial:  Initials Text field   ____I understand that ODAT Recovery Homes Inc will not give any refunds.

Residents will be required to provide all personal hygiene products such as toothbrushes, toothpaste, deodorant, body wash, shampoo, conditioner, high efficiency laundry detergent, and any other personal care product that the resident desires.

Initial: Initials Text field________ I understand that I am responsible for all personal hygiene products, as well as high efficiency laundry detergent.

Resident Name: Client first nameClient last name

Resident Signature: Signature

Entree Fee:_Text field___________________

Weekly : Text field