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Assessor: Date: His House Recovery Residence Assessment Referral Source: Name: (FIRST)(MIDDLE)Date of Assessment: / / Gender: M / F Age: (LAST)DOB: / / SSN: xxx xx xxx CHIEF COMPLAINT/PRECIPITATING

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What is his house recovery residence?

His house recovery residence is a place where individuals recovering from addiction can reside and receive support.

Who is required to file his house recovery residence?

The owner or operator of the house recovery residence is required to file it.

How to fill out his house recovery residence?

The house recovery residence can be filled out by providing information about the location, services offered, and number of residents.

What is the purpose of his house recovery residence?

The purpose of the house recovery residence is to provide a stable and supportive environment for individuals in recovery.

What information must be reported on his house recovery residence?

Information such as the address, contact information, services provided, and number of residents must be reported.

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