BEHAVIORAL CONTRACT EMPOWERING POTENTIAL HOUSING 

I, Client first name  Client last name, am a resident in Empowering Potential Recovery Home.  This is a sober living residence that provides an authentic peer to peer-based recovery support system.  While I reside here, I am encouraged to actively participate in my recovery and am expected to adhere to guidelines/rules implemented by management.

I am being placed on this Behavioral Contract for the following reason(s):

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I will set these immediate goals to help me change my action/behavior:

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Management will allow me until Date to meet my goals.

If I am unable to meet my goals, I may be asked to leave Empowering Potential Housing, without a refund of any monies paid.

Resident:Signature    

Date: Date

Manager: Signature     

Date:  Date

If resident refuses to sign, or any other issues please note here for interventions:

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