Abundant Hope Ministries

1808 Buffalo Trail Morristown, TN 37814

P: 423-254-1700 F:423-254-1701

We are a faith-based recovery program with 3 phases. In the 90-day immersive phase, participants undergo personalized assessments, counseling, community activities, daily spiritual foundations, celebrate recovery, and church services. Our 6-month Transition Phase is a bridge to real-world reintegration, emphasis is placed on fostering a sense of community engagement, finding employment or continued education, involvement in local churches and volunteer opportunities. Finally, in the 3-month Outpatient Phase, participants are ready for life with ongoing spiritual guidance, counseling, and peer support, ensuring sustained growth and resilience.

2 Corinthians 5:17 says “Therefore if anyone is in Christ, he is a new creation; the old is gone and the new has come.”

Please be informed that to be accepted into Abundant Hope, the Entry Assessment Form must be completed by the individual applying to the program. After receiving your application, we will review it and send a letter of acceptance or denial back to you. After receiving a letter of acceptance, you will be required to call or write us every week. If we do not hear from you, your name will be removed from the waiting list.

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Name

First Name

Last Name

Date

YYYY

Date of Birth

YYYY

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender

Phone

(###)

###

####

If accepted, what date would you be able to enter the program?

YYYY

Tell us what is currently happening in your life

Have you been to Abundant Hope Recovery Program in the past

If yes, please tell reason for leaving

Are you willing to complete all phases (immersive, transition and outpatient) of our recovery program?

Why is long-term treatment desired?

Do you have any longstanding health issues that concern you?

If yes, please give details.

List any allergies

Are you pregnant?

Are you disabled?

Do you receive Disability,SSI, or any compensation from the government?

List any medications you are taking and the reason the are prescribed.

Approved Mental Health Medications: Prozac (Fluoxetine) Paxil (Paroxetine) Zoloft (Sertraline) Celexa (Citalopram) Lexapro (Escitalopram) Viibryd (Vilazodone) Cymbalta (Duloxetine) Effexor (Venlafaxine) Trintellix (vortioxetine)

I attest that above information is true and all medications are prescribed for the labled purposes and are currently the only medication I am using.

Are you incarcerated?

If yes, where

TDOC Number

Attorney's name and phone number

Probation Officer's name, county, and phone number

Have you ever been convicted of a sexual offense?

Do you currently have sexual charges pending?

Are you required by a judge to complete a recovery program?

If yes, What is the name, county, and phone number of the judge?

List all cases you have been arrested for and all court dates:

What is your drug of choice?

Do you consider yourself an addict?

Explain:

There is a one-time fee of $215 when entering Abundant Hope Recovery Program. This fee in nonrefundable. By typing your name below you agree to the intake payment of $215.

Pay Intake Fee

Complete Background Check

Abundant Hope Ministries

1808 Buffalo Trail Morristown, TN 37814

P: 423-254-1700 F:423-254-1701

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