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Eligibility Requirements

See if our sober living home is the right one for you by viewing the below requirements.
For more information, please see below for a link to our Legacy House handbook.

  • Female 18 years or older.

  • Alcohol and drug free for at least 7 days.

  • Able to meet financial requirements (Minimum of $1800-$3500/month).

  • Completion of an inpatient alcohol and drug treatment program, or current attendance in an IOP or PHP program is preferred.

  • Must not be currently taking any narcotics, certain sleeping medications, benzodiazepines, stimulants, laxatives, and/or diet pills.

  • Negative drug screen and breathalyzer at time of admission.

  • You must agree to a personal property search upon admission and all property must be determined to be house and program appropriate.

  • Must provide emergency contact with consent for house staff to notify said contact in case of emergency. 

  • We are not able to accept residents with diagnosed Psychotic Disorder or Dissociative Identity Disorder at this time.

Legacy House Handbook

Legacy House

Residency Application

Resident Information

Multi-line address
If you go on overnight passes while with us is this where you plan on staying?
Birthday
Month
Day
Year

Choose one

Do you have children?

Emergency Contact Information

Relationship
Multi-line address

Legal Information

Do you have any legal issues?
Have you ever been convicted of a violent or sexual crime?

Demographic Information

Sex assigned at birth:
Gender Identity
Race/Ethnicity
Religious Preference

Education & Employment

Education
Are you currently employed or enrolled in school/training?
Household Income
Military Service
Yes
No

Addiction History

Drug of Choice
Have you ever relapsed?

Treatment & Recovery

Have you ever been in treatment?
Are you Current Enrolled in
Do you have sponsor?
In the last 30 days, have you attended
What step are you currently working on?

Health Information

1 star is very poor, and 5 stars is very good.

In the past 30 days have you experienced any of the following?
Are you currently pregnant?
Do you have health insurance?
Yes
No
Not sure

Transportation

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Closing Statements

Each resident of Legacy House has rights that the facility staff will safeguard during their stay. You have a right to:

□ Humane care in an environment that supports your recovery.

□ Be free from verbal and physical abuse.

□ Be treated with dignity and respect.

□ Choose your recovery goals.

□ Participate actively in your recovery.

□ Expect required services to occur during scheduled times and at designated locations.

□ Expect reasonable continuity of care, which includes schedules of services and at what times

staff and services are available.

□ Be given information regarding informed consent before the start of your stay.

□ Receive information regarding cost.

□ Be informed of the costs, potential benefits, and potential negative consequences of participating in this program.

□ Confidential records that are accessible only to designated staff and which can be released to others outside of Legacy House only with your written permission, except as allowed by state and federal law.

□ Be referred to subsequent services upon leaving or transfer from this facility.

□ Retain personal property that does not jeopardize your or others’ safety or health.

□ Receive and send unopened mail. I will always open received mail in the presence of a staff member when requested.

□ Be seen by a private physician with the understanding that all costs will be the responsibility of the resident.

□ File a complaint with the homeowner without fear of retaliation and have the complaint investigated within a reasonable amount of time.

□ Be fully informed before changes occur in these rights and responsibilities, as well as changes to Legacy House policies, procedures, program components, and schedule.

□ Know the qualifications of the staff involved in your care.

□ Refuse to stay and to be informed of the consequences of this action

□ Request referral resources in the event of my dismissal from Legacy House.

□ Not to be required to perform services for Legacy House, which are not included in the usual expectations of all residents

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Legacy House  |  913-963-5210 or 281-939-4459  |  Metropolitan Houston Area
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© 2019 by Digital Underground/Claire Green

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