Optional Coaching Request

A discussion worksheet for separate, nonclinical recovery coaching.

Complete and submit this initial inquiry online, or print / save a PDF. Required fields are marked. Submission does not guarantee admission, reserve a room, enroll you in coaching, or authorize payment. Do not include medical records, Social Security numbers, or payment details.

Name (required)Preferred contact information (required)

What would you like to work on?

Accountability and goal setting Daily routines and problem solving Recovery planning Employment goals Financial goals Community resources Independent living goalsQuestions for the coach (optional) I understand coaching is optional, separate from housing, and carries separate charges agreed in advance. (required) I understand coaching is not psychotherapy, medical treatment, or clinical addiction treatment. (required)

This worksheet does not enroll you in coaching or authorize any payment.

I consent to sending all information entered in this form by email to admin@sosrecovery.com for review and follow-up. Email is not a secure medical-record channel. I have read the privacy description. (required)

Leave this field empty

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For questions or a different way to return this form, call 272-207-8936. Admission is not guaranteed. An application does not reserve a room.

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S.O.S.RECOVERY HOUSE

Hope. Strength. Direction.
Mainesburg, Tioga County, Pennsylvania

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Private-pay, nonclinical recovery housing for adult men. Housing is not detoxification, medical care, psychotherapy, or clinical addiction treatment. Optional recovery coaching is separate from rent.