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Application

Restored Hope Ministries recognizes the challenges applicants face, and our top priority is to protect each individual from re-traumatization throughout the process. Taking this step toward hope and healing is courageous, and we are honored to accompany you on this journey.

 

Our program entails a minimum commitment of 12 months of residential therapy and care. Please note that completing this application does not ensure acceptance into our program; each application undergoes thorough review by our Program Director. If you meet the initial qualifications, we will proceed by scheduling a phone interview. Interviews are available Monday through Friday, from 9 AM to 4 PM, based on availability.

 

We commend you for taking this path toward healing.

Start Here

Birthday

Preliminary

Are you currently working with an advocate/mentor/case worker now?
Have you previously participated in a residential or outpatient program?

Current Situation

What level of education have you completed? Check all that apply.
Do you have a history of starting fires?
Do you have a history of physical fights?
Do you have a history of destroying property?
Do you have a history of running away?
Do you have a history of sexual abuse and trauma?
Are you currently in an abusive situation?
Are you currently on probation?
Please describe your current living situation
Are you or could you be currently pregnant?
Do you have any dependents?
Do you currently have custody of your children?
Do you suffer from or have been diagnosed with any of the following chronic health conditions?
Have you previously been hospitalized for psychiatric reasons?
Have you previously attempted suicide?
Are you currently in contact with someone from Restored Hope Ministries?
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