Gratitude Retreat Foundation
empowering newly recovering alcoholics
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Facility Criteria
Applications
New Facility
New Resident
30/60 Day Resident Evaluation
New Resident
New Resident Entry Form
Today's Date
Facility Name
*
Facility Contact Person / Representative
*
Facility Contact Phone Number
*
Facility Contact Email
*
Sober Applicant Name
*
Starting Bed Date
*
Ending Bed Date
*
How many days do you expect to need assistance for this sober applicant?
*
Notes/Special Requests
Is the sober applicant working or looking for work?
*
Working
Looking for Work
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