top of page

ONLINE INTAKE FORM

PLEASE REVIEW THE FOLLOWING BASIC ADMISSION CRITERIA: 

 

*Women over 18 who are survivors of sex trafficking, with addiction as a co-occurring disorder. 

*Able to perform basic activities, such as eating, bathing, movement 

* Willing to commit to a 18-24 month, faith based program for treatment and healing (no intimate relationships are allowed for residents) 

*Able to live in community and maintain appropriate behavior. 

*Willing to submit to and pass regular and random drug testing 

*Not on the sex offender registry 

 

DO YOU MEET THE ABOVE CRITERIA? IF YES, COMPLETE THE REMAINDER OF THE QUESTIONS.

Thanks for submitting!

bottom of page