• AHR Sponsor Ticket
  • AHR Sponsorship and Table Purchase
  • ARCO Leadership Summit 2019 Agenda
  • ARCO LS 2019 Session Detail Submission
  • ARCO Session Evaluation
  • Atlantic OHH
  • Beta Testing Feedback
  • Beyond Brink Full Consent Test
  • Burlington OHH
  • C4R Check-In
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  • C4R Member Registration
  • clr
  • Communities For Recovery
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  • Donate
  • F&V Contract
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  • First Time Visit
  • Focus RWC
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  • Illinois Stigma
  • Internal Survey
  • Kiosk 2.0 Template Form
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  • Kiosk A Way Forward Form
  • Kiosk AICDAC
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  • Kiosk Amethyst Recovery Form
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  • Kiosk Anderson Form
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  • Kiosk Beyond Brink Form
  • Kiosk BRCC
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  • Kiosk BRCC Form
  • Kiosk BRCC Visitor
  • Kiosk Cape Regional
  • Kiosk Cape Regional Form
  • Kiosk Communities for Recovery Form
  • Kiosk Communities for Recovery Spanish
  • Kiosk Communities for Recovery Testing
  • Kiosk Courage Center
  • Kiosk Courage Form
  • Kiosk Dee’s Place
  • Kiosk Dee’s Place Form
  • Kiosk DownEast Calais
  • Kiosk DownEast Calais Confirmation
  • Kiosk DownEast Calais Form
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  • Kiosk DownEast Machias
  • Kiosk DownEast Machias Confirmation
  • Kiosk DownEast Machias Form
  • Kiosk DownEast Machias Visitor
  • Kiosk FAVOR Upstate
  • Kiosk FAVOR Upstate Form
  • Kiosk FAVOR Western PA
  • Kiosk FAVOR Western PA Form
  • Kiosk Greenville
  • Kiosk Greenville Form
  • Kiosk Home 2.0 Template
  • Kiosk Home MOAR
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  • Kiosk Hope Coalition
  • Kiosk Hope Coalition Form
  • Kiosk Hope Rising
  • Kiosk Hope Rising Form
  • Kiosk Johnson City
  • Kiosk Johnson City Form
  • Kiosk Kentucky River District Health
  • Kiosk Kentucky River District Health Form
  • Kiosk LCRCC
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  • Kiosk Life Align
  • Kiosk Life Align Form
  • Kiosk Loudoun Serenity
  • Kiosk Loudoun Serenity Form
  • Kiosk LRRC
  • Kiosk LRRC Confirmation
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  • Kiosk Mountain Top Form
  • Kiosk MyPIR
  • Kiosk MyPIR Form
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  • Kiosk Never Alone Form
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  • Kiosk New Way Form
  • Kiosk NIRCO
  • Kiosk NIRCO Form
  • Kiosk Oconee
  • Kiosk Oconee Form
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  • Kiosk Pickens Form
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  • Kiosk R2RC Form
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  • Kiosk Reality Check
  • Kiosk Reality Check Form
  • Kiosk Recovery Beyond
  • Kiosk Recovery Beyond Form
  • Kiosk RioGrande
  • Kiosk RioGrande Form
  • Kiosk RioGrande2
  • Kiosk Rise Up Recovery
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  • Kiosk Rural Recovery Form
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  • Kiosk Sage’s Army Form
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  • Kiosk SALC Confirmation
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  • Kiosk Spartanburg
  • Kiosk Spartanburg Form
  • Kiosk SRCC
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  • Kiosk Template Form
  • Kiosk Trilogy
  • Kiosk Trilogy Form
  • Kiosk Turning Point
  • Kiosk Turning Point Form
  • Kiosk Turning Point of Chittenden County
  • Kiosk Turning Point of Chittenden County Form
  • Kiosk Wakeup
  • Kiosk Wakeup Form
  • Kiosk Will Work for Recovery
  • Kiosk Will Work for Recovery Form
  • LRCC
  • LRCC Activity Check-in
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  • Mercer OHH
  • NJ CARS Forms
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  • OHH Activity
  • OHH Kiosk RH
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  • PIK Consent
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  • RCCF Form
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  • RDP Agreements
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  • RDP LITE – COVID SURVEY
  • RDP Survey
  • Recovery Connection
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  • RMC NJ-CARS
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  • Sunrise Community for Recovery Wellness Kiosk
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  • This is a test.
  • Thriving U Kiosk
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  • USARA
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  • Website Feedback
  • Wilkes Recovery Revolution Kiosk
  • WRR Kiosk
  • Uncategorized
Faces & Voices of Recovery Data Hub

  • Check-In

    Please Check-In to an activity!

  • Request Contact

    Please provide the following information and we will get back to you shortly.
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    Section Break

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  • Your participant short code is your first initial, last initial, birth month, day and year in the following format: FL10211901 Where First Last's birth date is 10/21/1901.
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    Non-Participants can not check in for one-on-one sessions.
    Please fill our New Participant form below!
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    Request Contact

    Please provide the following information and we will get back to you shortly.
  • Your participant short code is your first initial, last initial, birth month, day and year in the following format: FL01311990 Where First Last's birth date is 01/31/1990.

  • New Participant

    Please create your new participant record.
  • If you don't have an email address, please input "no@email.com".
  • Please enter (000)-000-0000 if you do not have a phone number

  • Demographic Information

  • MM slash DD slash YYYY

  • Contact Preferences

  • The purpose of the disclosure authorized in this consent is to receive recovery support. I understand that my alcohol and/or drug treatment records are protected under the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 C.F.R. Pts. 160 &164 and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at any time. I understand and agree to the following: 1. I grant permission for a volunteer to call me at the above phone number, email, and/or address to support me in my recovery. 2. Each time the volunteer calls, he/she will be asking me how my recovery is progressing and if I am in need of additional support (i.e., meetings in area, recovery community centers, safe/sober housing, social events, other resources). 3. At the time of the call, if I am in need of a referral to a treatment program or detox unit, I will be assisted in finding a program, if I so desire. 4. If at any time I decide not to take part in this program, I will contact the center or tell the volunteer when he/she calls.

  • Monthly Assessments

    You will be completing the Brief Assessment of Recovery Capital (BARC). ALL fields are required.
  • Your participant short code is your first initial, last initial, birth month, day and year in the following format: FL10211901 Where First Last's birth date is 10/21/1901.
  • If you would like an email notification that you have submitted your assessment, please enter your email here.

  • Brief Assessment of Recovery Capital(BARC-10)

    Please indicate your level of agreement with the following statements: