Membership Application

I. Organizational Information

Company Billing Address
Company Mailing Address
Principal contact person

Will your organization attend the training workshops within 90 days of certification?

Does applicant own or operate a licensed or certified addiction or mental health program or facility?

Do any of the owners identified in this application have an ownership interest in or any sort of business relationship with a licensed, independent use, confirmatory lab?

If owners have any ownership in any other businesses in the recovery industry please disclose here:

Do you operate other types of housing?

Please fill out all fields to proceed

II Management and Staff Information

All owners, managers and staff are required to register with the credentialing entity (AzRHA). If the legal entity is a corporation with a large Board of Directors or is publically traded as is owned by a broad body shareholders, then the CEO and CFO may register as "Owners of Record". For each contact entered, a unique email address is required and a contact phone number that will be directly answered by that contact.
  • Main switchboard phone numbers and general inbox addresses are not permissible in the contact section of this application.
  • Failure to list all owners, managers, and staff constitutes a fraudulent application that may result in denial and/or revocation of your certificate of compliance.

III Standards, Code of Ethics, Dispute Resolution

Do you maintain formal standards for the operation of your recovery residences?

Do you maintain a code of ethics to which all members subscribe, or do your standards contain provisions equivalent to a code of ethics?

Do you agree to adopt the AzRHA Standard for Recovery Residences for all recovery residences operated by your organization?

Do you have a defined process for resolving complaints from residents and the public?

Do you maintain and follow procedures for logging and retaining records of complaints about your residences, and the manner in which they were resolved?

IV Support for AzRHA Mission

Are you willing to fully participate in AzRHA organizational activities?

Are you willing and able to support AzRHA-sponsored research initiatives?

Are you willing and able to contribute financially to the operation of NARR by payment of applicable annual affiliate fees?

Do you intend to conform to affiliate requirements which are enacted by AzRHA for adoption by its affiliates?

Do you agree to cooperate with PARR in efforts to resolve complaints received by PARR about the affiliate or about its individual members?

Have you read and do you understand the residence certification requirements?

Have you reviewed the health, safety and management requirements?

Have you read, and do you agree to abide by the Code of Ethics?

Have all responsible persons (see note) read, and signed, the Code of Ethics?

Note: A 'responsible person' is anyone in a position of authority or responsibility within the residence, including managers, house captains, senior residents, peer leaders and heads of household.

V Residences

General Information
Housing Capacity Information

Other space available?

Pool available?

Do you welcome Medically Assisted Treatment in your residences?

Is your residence abstinence based?

Recovery Path

Is food included in the fees?

Do you manage resident funds?

Costs
Residence Pictures

Thank you for your application - we will get in touch soon!