Recovery Residence Certification Application

Application for CTARR Affiliation

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Section 1 - Organizational Information

Initial Certification or Re-certification? *
For re-certification, if no changes since your last submission, complete Section 1 then skip to and complete Sections 6, 7 and Payment

Contact Information

Principal Business Address
Mailing Address
Principal Contact Person

Section 2 - Residences operated by this applicant

Please provide the following information for each recovery residence you operate. All recovery residences you operate must be included. 

Accepts Minors?





 

Section 3 - Standards, codes of ethics, dispute resolution

Do you maintain formal standards for the operation of your recovery residences? *
Do you maintain a code of ethics to which all members subscribe, or do your standards contain provisions equivalent to a code of ethics? *
Do you agree to adopt the CTARR Standard for Recovery Residences for all recovery residences operated by your organization? *
Do you have a defined process for resolving complaints from residents and the public? *
Do you maintain and follow procedures for logging and retaining records of complaints about your residences, and the manner in which they were resolved? *

Section 4 - Support for CTARR activities and mission

Are you willing to participate in CTARR activities and programs? *
Are you willing and able to support CTARR-sponsored research initiatives? *
Are you willing and able to contribute financially to the operation of CTARR by payment of applicable annual affiliate fees? *
Do you intend to conform to affiliate requirements which are enacted by CTARR for adoption by its affiliates? *
Do you intend to conform to affiliate requirements which are enacted by CTARR for adoption by its affiliates? Copy *

Section 5 - Annual fees

Affiliate fees for recovery residence providers are based on residential capacity. This section will help you calculate the affiliate fee for your organization based on your capacity. Enter the total number of beds for each individual residence you are registering.

The Total Amount Due (shown at the bottom of the page) is the sum of the $300 application fee, $100 for each additional recovery residence and the capacity-based charges based on your capacity.

Section 6 - Supporting documentation

Please save all files as PDF's before attempting upload

One letter of recommendation, emailed by reference source directly to CTARR info@ctrecoveryresidences.org

Section 7 - Certification

Certification I certify that this application is supported by the applicant organization named above, and that I am authorized to submit this application on its behalf.

Payment

Payment - your application will not be processed unless payment is received

Annual Application Fee: $300*

Enter Number of Additional Houses @ $100

Bed Fee @ $1.00 - Enter total bed amount: 

Total: $300.00

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