Start here. Leave blank anything you do not know.
This is not an application you can fail. It is enough for us to call you back knowing roughly where you are, so you do not have to tell the story twice.
Would you rather just talk?
Nothing on this page is faster than a phone call.
661-805-0527Or email Eric@aftermathrehabilitation.com
What happens next
- We call you back about availability.
- A conversation about expectations, both ways.
- You come and see the home.
- We go through the house agreement out loud, then you move in.
Free. Confidential. Commits you to nothing. See our privacy notice.
Please keep medical detail off this form. We are housing, not a clinical
program, and we do not need your health record. A general note is plenty, and anything else is
better said on the phone.
Received
That is the hard part done.
Somebody will call you about availability. If you would rather not wait, ring 661-805-0527 now and say you just sent the form.
Nothing needs preparing. Bring yourself and a bag when the time comes.