Be a Guest

If you need a safe temporary home as you get ready for the next part of your life, complete the Referral Form to start the process. Hospitality House staff will contact you within 24-48 hours to set up an intake interview. Hospitality House accepts self-referrals and referrals from community agencies.

Get in touch

Applicant's First Name

Applicant's Last Name

Phone

Please describe current situation

Have you resided in Steele County for more than 30 days? *

Yes

Have you stayed at HHO before? How Many Times and when? Please Note that HHO prioritizes individuals who have never stayed.

Applicant's Date of Birth

Do you have a mental health diagnosis? *

Yes

Have you had any mental health hospitalizations? *

Yes

Please list the Mental Health Providers that you are working with:

Do you have a history of substance use? If yes, please explain:

HHO is a sober living environment. Are you willing to abstain from all mood-altering chemicals (besides prescribed medications)during your stay at HHO? *

Yes

Will you be able to pass a drug screen prior to admittance? If No, please explain:

Please list any medical conditions that require special care or prescriptions that you currently take:

Do you have any physical limitations for walking up and down stairs? *

Yes

Do you have a current or previous criminal history, including arrests? If yes, please provide details:

Do you give consent to Hospitality House to check your criminal history? *

Yes

Name of person and agency making referral

Phone number of person making a referral: Please note: HHO may call agency or person making the referral for collaborative information.

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