Lifting The fallen House LLC

At Lifting The Fallen House LLC, we maintain a structured, substance-free, and supportive sober living environment for men committed to recovery. Whether you’re seeking a safe place to continue your journey, asking questions about our Sober Home, or referring a loved one — we’re here to help.

All inquiries are confidential. Your path to healing and stability begins here.

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Name *

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Last

Email *

Phone Number *

Preferred Contact Method *— Select Choice —EmailPhoneEither

Are you contacting us for yourself or someone else? *— Select Choice —For myselfFor a friend or family memberFor a professional referralJust looking for more information

What type of support are you looking for? (Select all that apply) *

• General questions about the Sober Home
• Sober living residence for myself
• Sober living for someone else
• Referral or partnership
• Other (Please explain below)

Other:

Please explain type of support if you selected “Other” on the checkboxes above.

Are you or the other person you're inquiring for currently sober? *— Select Choice —Yes, currently soberNo, seeking support to get soberIn treatment right nowPrefer not to say

When are you hoping to move in or have someone move in? *— Select Choice —ImmediatelyWithin 1 weekWithin 30 daysJust exploring options

Tell us more about your situation or what you're looking for. *

How did you hear about us? *Word of mouthReferral from a treatment programSocial mediaOnline searchMASH websiteOther

Privacy Notice: All information shared is confidential and used only to help us provide support or begin the move-in process. Lifting The Fallen House LLC complies with all applicable housing, nondiscrimination, and privacy laws.

THIS NOTICE are

BY CHECKING THIS BOX I CONFIRM TO HAVE READ THE IMPORTANT NOTICE BEFORE SUBMITTING *

• IMPORTANT NOTICE: Lifting The Fallen House LLC does not accept referrals from the Behavioral Health Network (BHN) Recovery Coach Program, nor from any individual affiliated with that specific program. However, we may accept applications from individuals who are or were associated with other BHN services, as long as no referral or coordination is made through the Recovery Coach Program. Each applicant must still meet all standard eligibility and conflict of interest requirements. By submitting this form, you confirm that you are not being referred by the BHN Recovery Coach Program and that there is no conflict of interest related to your application.

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