Telephone Recovery Support

Need some extra support with your recovery? Let CRUSH RCC Staff be there when it's convienent for you. Please fill out this form and be supported.

Telephone Recovery Support Form

First Name

Last Name

Birthday

Phone

City

Your Pronouns

Region/State/Province

Postal / Zip code

Referred By:

Gender

Telephone Recovery Support calls are made between 9 am and 5 pm Central Time Monday through Friday. Please select the time range that reflects when you would like to be called.

Days To Call

Best Time to call

Choose a time

I understand and agree to the following:

1. I grant permission for a volunteer from Crush Recovery Community Center to call me weekly on the above telephone number(s) to support me in my recovery.

2. Each time the Crush Recovery Community Center 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 a 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. At any time I may decide not to take part in this service, I will call Crush Recovery Community Center at 319-214-9567 or tell the volunteer when he/she calls.

I agree to the terms & conditions

Thanks for submitting!