Apply for Sober Living | AfterHouse Recovery Des Moines

Complete the form below and we will review your application personally. Need help? Call 515-518-9417 or email Shawn.Jarrett@afterhouserecov.co.

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Application received.

Thank you for your application. We'll review it and contact you within 48 hours. If you need immediate assistance, call 515-518-9417.

1Personal Information

Full Name *

Date of Birth *

Phone Number *

Email Address *

2Recovery Background

Current Living Situation (optional)

Treatment History (optional)

Sobriety Date (optional)

Substance(s) of Choice (optional)

Are you currently employed? (optional)

YesNo

3Emergency Contact

Name *

Relationship (optional)

Phone *

4A Little More

How did you hear about AfterHouse? (optional)

Anything else you'd like us to know? (optional)

I understand AfterHouse Recovery is a sober living environment and I commit to maintaining sobriety while residing here. *

Des Moines, Iowa · Adults 18+ · Questions? Harley.Crusan@afterhouserecov.co