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Request a Quote

Referral Form

Relationship to Applicant
Men or Women's?
Is the applicant medically and psychiatrically stable for independent shared housing?
Is the applicant on any MAT or on any other medications that require a lockbox ?
Does the applicant have a known history of violence, arson, sexual offenses, or other safety concerns relevant to shared housing?
Proposed payment source
Has the applicant agreed to be contacted by Jax Recovery Homes?

Thank you so much for partnering with us! Someone from our team will contact you and discuss bed availability within one business day.

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Every applicant must complete an individual screening and agree to the residence’s standards and financial requirements.

Thanks for submitting! Our team member will contact you as soon as we can -within one business day. If urgent, please call us directly. Have a great day!

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National Association of Recovery Residence
USFCR Vendor
Texas Recovery Association

Shalom House Foundation, Inc.
501(c)(3) nonprofit organization: EIN 87-2437765
Operating recovery housing programs in Florida under: Jax Recovery Homes
Former Texas program: Katy Recovery Homes — historical operating experience

© 2024 by Shalom House Foundation

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