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Apply for Sober Living

Submitting an application is the first step. Admissions will follow up to schedule a short conversation and review program expectations.

See the Admissions Process I'm a Professional Referring Someone Join the Bed Waiting List / Request Resources

No beds open right now?

Submit a resource request to join our bed waiting list and get matched to jobs, training, education, transitional living, veterans, homeless, and mental health services in the meantime.

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Confidential Application

Tell us how we can help

Please do not include Social Security numbers, insurance numbers, or medical records. Sensitive information is collected securely later in the process.

Applicant information

Full legal name *

Date of birth *

Phone *

Email *

Current address

Emergency contact

Housing & placement

Referral source

Current housing situation

Employment status

Requested move-in date

Income source

Transportation needs

Recovery support

Recovery support currently being used

Current treatment provider (if applicable)

Probation / parole involvement (if applicable)

Medications

Share only what you are comfortable providing here. Detailed information is collected securely during the admissions conversation.

Accessibility / accommodation request

Additional information

I confirm the information provided is accurate and I consent to Eelysium Behavior Health Inc. contacting me about recovery housing. I understand this application is not a guarantee of placement, that Eelysium provides sober living and peer support rather than clinical treatment, and that my information is kept confidential and shared only with authorized staff.

For your privacy, please do not submit Social Security numbers, insurance numbers, or detailed medical records through this form.