{"id":195,"date":"2018-11-02T16:21:55","date_gmt":"2018-11-02T16:21:55","guid":{"rendered":"https:\/\/northstarregional.com\/?page_id=195"},"modified":"2024-03-21T13:04:28","modified_gmt":"2024-03-21T18:04:28","slug":"application","status":"publish","type":"page","link":"https:\/\/northstarregional.com\/housing\/application\/","title":{"rendered":"Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"195\" class=\"elementor elementor-195\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5b4933dc elementor-hidden-phone elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"5b4933dc\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-21f860ad\" data-id=\"21f860ad\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-663b7c69 elementor-widget elementor-widget-heading\" data-id=\"663b7c69\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Application<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7db0e456 elementor-widget elementor-widget-text-editor\" data-id=\"7db0e456\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>This application is for sober housing, not for housing during treatment. If you need housing while in treatment, please <a href=\"https:\/\/northstarregional.com\/contact\/\">contact us<\/a> for more information.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-59b1a532\" data-id=\"59b1a532\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-50f1fabe elementor-section-full_width elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-widescreen elementor-hidden-tablet_extra elementor-section-height-default elementor-section-height-default\" data-id=\"50f1fabe\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2c76fe06\" data-id=\"2c76fe06\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2b0f17fa elementor-widget elementor-widget-image\" data-id=\"2b0f17fa\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/northstarregional.com\/wp-content\/uploads\/elementor\/thumbs\/application-mobile-pq0lx4kje36jxhisuwmsp6ochs96n82fnwbdvtuehc.jpg\" title=\"application-mobile\" alt=\"sober housing living room\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-41b59c83 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-widescreen elementor-hidden-tablet_extra elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"41b59c83\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6eb45387\" data-id=\"6eb45387\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3b4ab95d elementor-widget elementor-widget-heading\" data-id=\"3b4ab95d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Application<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-78fadaf8 elementor-widget elementor-widget-text-editor\" data-id=\"78fadaf8\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tThis application is for sober housing, not for housing during treatment. If you need housing while in treatment, please <a href=\"https:\/\/nsr.northlandcounselingservices.org\/contact\/\">contact us<\/a> for more information.\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-48006345 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"48006345\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-52665459\" data-id=\"52665459\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7ef027dd elementor-widget elementor-widget-heading\" data-id=\"7ef027dd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Getting Started<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3b9b41b0 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"3b9b41b0\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-69724f72 elementor-widget elementor-widget-heading\" data-id=\"69724f72\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Instructions<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-24312448 elementor-widget elementor-widget-text-editor\" data-id=\"24312448\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tTo apply to be a resident at one of NorthStar Regional\u2019s Sober Homes, please read the information below and complete the form to the best of your ability. If you choose, you can download a version of this form that can be completed, printed, and shared back to the Admissions Team at NorthStar Regional.\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-397d062e elementor-mobile-align-center elementor-widget__width-auto elementor-widget-mobile__width-inherit elementor-widget elementor-widget-button\" data-id=\"397d062e\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#housing-application\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Complete Online Application<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-57c77d0d elementor-mobile-align-center elementor-widget__width-auto elementor-widget-mobile__width-inherit elementor-widget elementor-widget-button\" data-id=\"57c77d0d\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2024\/03\/Sober-Housing-Agreement-3.21.24.docx\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Download Application<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a1609b6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a1609b6\" data-element_type=\"section\" id=\"housing-application\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2af35734\" data-id=\"2af35734\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6ba09fb1 elementor-widget elementor-widget-heading\" data-id=\"6ba09fb1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Online Application<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-29319f13 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"29319f13\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7b593790 elementor-widget elementor-widget-heading\" data-id=\"7b593790\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Sober Housing Application<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-75854c04 elementor-widget elementor-widget-shortcode\" data-id=\"75854c04\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_6' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/wp-json\/wp\/v2\/pages\/195' data-formid='6' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_6' class='gform_fields top_label form_sublabel_above description_above'><div id=\"field_6_13\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_13\" ><h3 class=\"gsection_title\">Resident Information<\/h3><\/div><fieldset id=\"field_6_14\" class=\"gfield gfield--type-name hipaa_forms_name gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_14\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_6_14'>\n                            \n                            <span id='input_6_14_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_6_14_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_14.3' id='input_6_14_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            <span id='input_6_14_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_6_14_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                    <input type='text' name='input_14.4' id='input_6_14_4' value=''   aria-required='false'     \/>\n                                                <\/span>\n                            <span id='input_6_14_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_6_14_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_14.6' id='input_6_14_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_6_15\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_15\" ><label class='gfield_label gform-field-label' for='input_6_15'>DOB<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_15' id='input_6_15' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_15_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_15_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_15' class='gform_hidden' value='https:\/\/northstarregional.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_16\" class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_16\" ><label class='gfield_label gform-field-label' for='input_6_16'>Age<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_6_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_17\" class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_17\" ><label class='gfield_label gform-field-label' for='input_6_17'>Last 4 of SS#<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_6_17' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_21\" class=\"gfield gfield--type-text gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_21\" ><label class='gfield_label gform-field-label' for='input_6_21'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_6_21' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_143\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_143\" ><legend class='gfield_label gform-field-label' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_143'>\n\t\t\t<div class='gchoice gchoice_6_143_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_143' type='radio' value='Male'  id='choice_6_143_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_143_0' id='label_6_143_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_143_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_143' type='radio' value='Female'  id='choice_6_143_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_143_1' id='label_6_143_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_144\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_144\" ><legend class='gfield_label gform-field-label' >Are you required to reside in a certain county?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_144'>\n\t\t\t<div class='gchoice gchoice_6_144_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_144' type='radio' value='Yes'  id='choice_6_144_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_144_0' id='label_6_144_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_144_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_144' type='radio' value='No'  id='choice_6_144_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_144_1' id='label_6_144_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_145\" class=\"gfield gfield--type-html gfield--width-quarter gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_145\" ><\/div><div id=\"field_6_146\" class=\"gfield gfield--type-html gfield--width-quarter gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_146\" ><\/div><fieldset id=\"field_6_26\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_6_26\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_26' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_26_1_container' >\n                                        <label for='input_6_26_1' id='input_6_26_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_26.1' id='input_6_26_1' value=''    aria-required='true'   autocomplete=\"address-line1\" \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_26_2_container' >\n                                        <label for='input_6_26_2' id='input_6_26_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_26.2' id='input_6_26_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_26_3_container' >\n                                    <label for='input_6_26_3' id='input_6_26_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_26.3' id='input_6_26_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_26_4_container' >\n                                        <label for='input_6_26_4' id='input_6_26_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_26.4' id='input_6_26_4'     aria-required='true'   autocomplete=\"address-level1\" ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_26_5_container' >\n                                    <label for='input_6_26_5' id='input_6_26_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_26.5' id='input_6_26_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_26.6' id='input_6_26_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_6_154\" class=\"gfield gfield--type-email gfield--width-quarter hipaa_forms_email gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_154\" ><label class='gfield_label gform-field-label' for='input_6_154'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_154' id='input_6_154' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_6_27\" class=\"gfield gfield--type-phone gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_27\" ><label class='gfield_label gform-field-label' for='input_6_27'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_27' id='input_6_27' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_28\" class=\"gfield gfield--type-phone gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_28\" ><label class='gfield_label gform-field-label' for='input_6_28'>Cell Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_28' id='input_6_28' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_29\" class=\"gfield gfield--type-phone gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_29\" ><label class='gfield_label gform-field-label' for='input_6_29'>Other Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_29' id='input_6_29' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_6_30\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_30\" ><label class='gfield_label gform-field-label' for='input_6_30'>If applicable, name of the treatment center, institution, or facility released from:<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_6_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_31\" ><legend class='gfield_label gform-field-label' >A completed Release of Information (ROI) document is required for new clients arriving to NorthStar Regional. Has this been completed?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_31'>\n\t\t\t<div class='gchoice gchoice_6_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Yes'  id='choice_6_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_31_0' id='label_6_31_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='No'  id='choice_6_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_31_1' id='label_6_31_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_114\" class=\"gfield gfield--type-html gfield--width-third gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_114\" >If not, download and complete the Release of Information document below: <br><b><a href=https:\/\/northstarregional.com\/wp-content\/uploads\/2020\/03\/NSR-External-ROI.pdf target=\"_blank\" rel=\"noopener noreferrer\">NorthStar Regional Release of Information<\/a><\/b><br>\nOnce complete, please share this document with NorthStar Regional staff.<\/div><div id=\"field_6_122\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_122\" ><\/div><div id=\"field_6_124\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_124\" ><\/div><div id=\"field_6_123\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_123\" ><\/div><div id=\"field_6_32\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_32\" ><h3 class=\"gsection_title\">Financial Information<\/h3><\/div><fieldset id=\"field_6_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_33\" ><legend class='gfield_label gform-field-label' >Are you capable of paying rent?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_33'>\n\t\t\t<div class='gchoice gchoice_6_33_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='Yes'  id='choice_6_33_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_33_0' id='label_6_33_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_33_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_33' type='radio' value='No'  id='choice_6_33_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_33_1' id='label_6_33_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_34\" ><legend class='gfield_label gform-field-label' >How will rent be paid?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_34'>\n\t\t\t<div class='gchoice gchoice_6_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='HSF'  id='choice_6_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_34_0' id='label_6_34_0' class='gform-field-label gform-field-label--type-inline'>HSF<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Self'  id='choice_6_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_34_1' id='label_6_34_1' class='gform-field-label gform-field-label--type-inline'>Self<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_34_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Friend \/ Family'  id='choice_6_34_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_34_2' id='label_6_34_2' class='gform-field-label gform-field-label--type-inline'>Friend \/ Family<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_35\" ><legend class='gfield_label gform-field-label' >Currently employed?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_35'>\n\t\t\t<div class='gchoice gchoice_6_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Yes'  id='choice_6_35_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_35_0' id='label_6_35_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='No'  id='choice_6_35_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_35_1' id='label_6_35_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_36\" ><legend class='gfield_label gform-field-label' >Capable of working \/ volunteering?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_36'>\n\t\t\t<div class='gchoice gchoice_6_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Yes'  id='choice_6_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_36_0' id='label_6_36_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='No'  id='choice_6_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_36_1' id='label_6_36_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_37\" ><legend class='gfield_label gform-field-label' >Housing Support Funding (HSF) Eligible<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_37'>\n\t\t\t<div class='gchoice gchoice_6_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='Yes'  id='choice_6_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_37_0' id='label_6_37_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='No'  id='choice_6_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_37_1' id='label_6_37_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_38\" ><legend class='gfield_label gform-field-label' >If HSF funded, have you completed our HS financial intake form?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_38'>\n\t\t\t<div class='gchoice gchoice_6_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_6_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_38_0' id='label_6_38_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_6_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_38_1' id='label_6_38_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_115\" class=\"gfield gfield--type-html gfield--width-quarter gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_115\" >The Housing Support program provides help for housing costs for some people at risk of institutional placement or homelessness. For more information, click <b><a href=https:\/\/mn.gov\/dhs\/people-we-serve\/adults\/economic-assistance\/housing\/programs-and-services\/housing-support.jsp target=\"_blank\" rel=\"noopener noreferrer\">this link<\/a>.<\/b><\/div><div id=\"field_6_116\" class=\"gfield gfield--type-html gfield--width-quarter gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_116\" ><\/div><div id=\"field_6_125\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_125\" ><\/div><div id=\"field_6_127\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_127\" ><\/div><div id=\"field_6_126\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_126\" ><\/div><div id=\"field_6_39\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_39\" ><h3 class=\"gsection_title\">Chemical Use History \/ Legal Involvement<\/h3><\/div><div id=\"field_6_40\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_40\" ><label class='gfield_label gform-field-label' for='input_6_40'>Sober Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_6_40' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_41\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_41\" ><label class='gfield_label gform-field-label' for='input_6_41'>Drug of Choice<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_6_41' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_44\" ><legend class='gfield_label gform-field-label' >Can you pass a drug test today?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_44'>\n\t\t\t<div class='gchoice gchoice_6_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Yes'  id='choice_6_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_44_0' id='label_6_44_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='No'  id='choice_6_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_44_1' id='label_6_44_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_45\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_45\" ><label class='gfield_label gform-field-label' for='input_6_45'>List types of drugs used\/abused in the past 12 months:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_6_45' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_46\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_46\" ><label class='gfield_label gform-field-label' for='input_6_46'>Lifetime number of DWIs<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_6_46' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_47\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_47\" ><label class='gfield_label gform-field-label' for='input_6_47'>Lifetime number of possession charges<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_6_47' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_48\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_48\" ><label class='gfield_label gform-field-label' for='input_6_48'>Lifetime number of assaults<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_6_48' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_49\" ><legend class='gfield_label gform-field-label' >Have you ever been charged with a sex crime?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_49'>\n\t\t\t<div class='gchoice gchoice_6_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Yes'  id='choice_6_49_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_49_0' id='label_6_49_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='No'  id='choice_6_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_49_1' id='label_6_49_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_50\" class=\"gfield gfield--type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_50\" ><label class='gfield_label gform-field-label' for='input_6_50'>If yes, what crime and when?<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_6_50' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_51\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_51\" ><legend class='gfield_label gform-field-label' >Have you ever been convicted of arson?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_51'>\n\t\t\t<div class='gchoice gchoice_6_51_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='Yes'  id='choice_6_51_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_51_0' id='label_6_51_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_51_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_51' type='radio' value='No'  id='choice_6_51_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_51_1' id='label_6_51_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_52\" class=\"gfield gfield--type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_52\" ><label class='gfield_label gform-field-label' for='input_6_52'>If yes, what crime and when?<\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_6_52' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_53\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_53\" ><legend class='gfield_label gform-field-label' >Check one:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_53'>\n\t\t\t<div class='gchoice gchoice_6_53_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='None'  id='choice_6_53_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_53_0' id='label_6_53_0' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_53_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Probation'  id='choice_6_53_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_53_1' id='label_6_53_1' class='gform-field-label gform-field-label--type-inline'>Probation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_53_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Parole'  id='choice_6_53_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_53_2' id='label_6_53_2' class='gform-field-label gform-field-label--type-inline'>Parole<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_53_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Pre-Trial'  id='choice_6_53_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_53_3' id='label_6_53_3' class='gform-field-label gform-field-label--type-inline'>Pre-Trial<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_54\" class=\"gfield gfield--type-text gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_54\" ><label class='gfield_label gform-field-label' for='input_6_54'>State &amp; County<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_6_54' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_55\" class=\"gfield gfield--type-text gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_55\" ><label class='gfield_label gform-field-label' for='input_6_55'>Parole \/ Probation Name<\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_6_55' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_63\" class=\"gfield gfield--type-text gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_63\" ><label class='gfield_label gform-field-label' for='input_6_63'>Parole or Probation Agent Phone<\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_6_63' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_128\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_128\" ><\/div><div id=\"field_6_130\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_130\" ><\/div><div id=\"field_6_129\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_129\" ><\/div><div id=\"field_6_58\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_58\" ><h3 class=\"gsection_title\">Physical &amp; Mental Health<\/h3><\/div><fieldset id=\"field_6_59\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_59\" ><legend class='gfield_label gform-field-label' >Are you under a physician&#039;s care?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_59'>\n\t\t\t<div class='gchoice gchoice_6_59_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Yes'  id='choice_6_59_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_59_0' id='label_6_59_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_59_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='No'  id='choice_6_59_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_59_1' id='label_6_59_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_61\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_61\" ><label class='gfield_label gform-field-label' for='input_6_61'>Doctor&#039;s Name<\/label><div class='ginput_container ginput_container_text'><input name='input_61' id='input_6_61' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_62\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_62\" ><label class='gfield_label gform-field-label' for='input_6_62'>Doctor&#039;s Phone<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_6_62' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_148\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_148\" ><legend class='gfield_label gform-field-label' >Are you under a psychologist&#039;s care?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_148'>\n\t\t\t<div class='gchoice gchoice_6_148_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='Yes'  id='choice_6_148_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_148_0' id='label_6_148_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_148_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_148' type='radio' value='No'  id='choice_6_148_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_148_1' id='label_6_148_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_149\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_149\" ><label class='gfield_label gform-field-label' for='input_6_149'>Psychologist&#039;s Name<\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_6_149' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_150\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_150\" ><label class='gfield_label gform-field-label' for='input_6_150'>Psychologist&#039;s Phone<\/label><div class='ginput_container ginput_container_text'><input name='input_150' id='input_6_150' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_153\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_153\" ><legend class='gfield_label gform-field-label' >Are you under a psychiatrist&#039;s care?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_153'>\n\t\t\t<div class='gchoice gchoice_6_153_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_153' type='radio' value='Yes'  id='choice_6_153_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_153_0' id='label_6_153_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_153_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_153' type='radio' value='No'  id='choice_6_153_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_153_1' id='label_6_153_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_152\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_152\" ><label class='gfield_label gform-field-label' for='input_6_152'>Psychiatrist&#039;s Name<\/label><div class='ginput_container ginput_container_text'><input name='input_152' id='input_6_152' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_151\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_151\" ><label class='gfield_label gform-field-label' for='input_6_151'>Psychiatrist&#039;s Phone<\/label><div class='ginput_container ginput_container_text'><input name='input_151' id='input_6_151' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_64\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_64\" ><legend class='gfield_label gform-field-label' >Are you under a therapist&#039;s care?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_64'>\n\t\t\t<div class='gchoice gchoice_6_64_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='Yes'  id='choice_6_64_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_64_0' id='label_6_64_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_64_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_64' type='radio' value='No'  id='choice_6_64_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_64_1' id='label_6_64_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_65\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_65\" ><label class='gfield_label gform-field-label' for='input_6_65'>Therapist&#039;s Name<\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_6_65' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_66\" class=\"gfield gfield--type-text gfield--width-third field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_66\" ><label class='gfield_label gform-field-label' for='input_6_66'>Therapist&#039;s Phone<\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_6_66' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_68\" class=\"gfield gfield--type-text gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_68\" ><label class='gfield_label gform-field-label' for='input_6_68'>Mental Health Diagnosis<\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_6_68' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_70\" class=\"gfield gfield--type-text gfield--width-quarter field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_70\" ><label class='gfield_label gform-field-label' for='input_6_70'>Prescribed Medications<\/label><div class='ginput_container ginput_container_text'><input name='input_70' id='input_6_70' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_69\" ><legend class='gfield_label gform-field-label' >Ever planned suicide?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_69'>\n\t\t\t<div class='gchoice gchoice_6_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Yes'  id='choice_6_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_69_0' id='label_6_69_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='No'  id='choice_6_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_69_1' id='label_6_69_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_6_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-quarter gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_71\" ><legend class='gfield_label gform-field-label' >Ever attempted suicide?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_6_71'>\n\t\t\t<div class='gchoice gchoice_6_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_6_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_71_0' id='label_6_71_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_6_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_6_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_6_71_1' id='label_6_71_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_6_131\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_131\" ><\/div><div id=\"field_6_133\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_133\" ><\/div><div id=\"field_6_132\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_132\" ><\/div><div id=\"field_6_72\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_72\" ><h3 class=\"gsection_title\">Emergency Contact<\/h3><\/div><div id=\"field_6_73\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_73\" ><label class='gfield_label gform-field-label' for='input_6_73'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_6_73' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_74\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_74\" ><label class='gfield_label gform-field-label' for='input_6_74'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_6_74' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_75\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_75\" ><label class='gfield_label gform-field-label' for='input_6_75'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_6_75' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_6_76\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_76\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_76' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_76_1_container' >\n                                        <label for='input_6_76_1' id='input_6_76_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_76.1' id='input_6_76_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_76_2_container' >\n                                        <label for='input_6_76_2' id='input_6_76_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_76.2' id='input_6_76_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_76_3_container' >\n                                    <label for='input_6_76_3' id='input_6_76_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_76.3' id='input_6_76_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_76_4_container' >\n                                        <label for='input_6_76_4' id='input_6_76_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <input type='text' name='input_76.4' id='input_6_76_4' value=''      aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_76_5_container' >\n                                    <label for='input_6_76_5' id='input_6_76_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_76.5' id='input_6_76_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_76.6' id='input_6_76_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_6_134\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_134\" ><\/div><div id=\"field_6_136\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_136\" ><\/div><div id=\"field_6_135\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_135\" ><\/div><div id=\"field_6_77\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_77\" ><h3 class=\"gsection_title\">All lines must be initialed by the participant for application to be accepted.<\/h3><\/div><div id=\"field_6_80\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_80\" ><label class='gfield_label gform-field-label' for='input_6_80'>I have a clear understanding of all expectations outlined in the lodging agreement.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_6_80' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_83\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_83\" ><label class='gfield_label gform-field-label' for='input_6_83'>I agree to actively work with a sponsor on a weekly basis.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_6_83' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_85\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_85\" ><label class='gfield_label gform-field-label' for='input_6_85'>I will attend a minimum of three published 12 step meetings\/week &amp; provide signature cards.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_85' id='input_6_85' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_86\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_86\" ><label class='gfield_label gform-field-label' for='input_6_86'>I will not enter establishments that predominantly serve alcohol.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_86' id='input_6_86' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_87\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_87\" ><label class='gfield_label gform-field-label' for='input_6_87'>I will not enter casinos or gambling establishments without prior written consent.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_6_87' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_96\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_96\" ><label class='gfield_label gform-field-label' for='input_6_96'>I will not gamble online, in establishments, with lottery tickets, at private parties or in the home.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_96' id='input_6_96' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_95\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_95\" ><label class='gfield_label gform-field-label' for='input_6_95'>I will abide by all house policies outlined in the lodging agreement which I have signed.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_95' id='input_6_95' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_94\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_94\" ><label class='gfield_label gform-field-label' for='input_6_94'>I will not use drugs, alcohol or any other mind-altering substances.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_6_94' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_93\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_93\" ><label class='gfield_label gform-field-label' for='input_6_93'>I have not used benzodiazepine class drugs for the 6 weeks prior to scheduled admission date.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_93' id='input_6_93' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_92\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_92\" ><label class='gfield_label gform-field-label' for='input_6_92'>I will attend the mandatory weekly house meeting.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_92' id='input_6_92' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_91\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_91\" ><label class='gfield_label gform-field-label' for='input_6_91'>I will complete all household chores assigned each week by the resident assistant.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_91' id='input_6_91' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_90\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_90\" ><label class='gfield_label gform-field-label' for='input_6_90'>I will only smoke in the single outdoor designated smoking area.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_90' id='input_6_90' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_89\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_89\" ><label class='gfield_label gform-field-label' for='input_6_89'>I understand any personal property left at the home after I vacate will be disposed or donated.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_6_89' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_88\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_88\" ><label class='gfield_label gform-field-label' for='input_6_88'>I understand that NorthStar Regional is not liable for loss or theft of my personal property.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_6_88' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_97\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_97\" ><label class='gfield_label gform-field-label' for='input_6_97'>I will treat everyone in the facility, neighbors and staff with courtesy and respect.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_97' id='input_6_97' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_99\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_99\" ><label class='gfield_label gform-field-label' for='input_6_99'>I will be law abiding and may be discharged for any legal violation.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_99' id='input_6_99' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_98\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_98\" ><label class='gfield_label gform-field-label' for='input_6_98'>I understand only family members, PO&#039;s, caseworkers, and same sex sponsors are permitted on site, a max of 60 min.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_98' id='input_6_98' type='text' value='' class='small'    placeholder='Initial Here' aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_117\" class=\"gfield gfield--type-html gfield--width-third gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_117\" ><\/div><div id=\"field_6_137\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_137\" ><\/div><div id=\"field_6_139\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_139\" ><\/div><div id=\"field_6_138\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_138\" ><\/div><div id=\"field_6_100\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_100\" ><h3 class=\"gsection_title\">By signing or typing your full name below you agree that all information provided is true and accurate to the best of your knowledge. You also agree that you have a clear understanding of each initialed box above.<\/h3><\/div><div id=\"field_6_101\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_101\" ><label class='gfield_label gform-field-label' for='input_6_101'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_101' id='input_6_101' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_102\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_102\" ><label class='gfield_label gform-field-label' for='input_6_102'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_102' id='input_6_102' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_102_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_102_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_102' class='gform_hidden' value='https:\/\/northstarregional.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_103\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_103\" >The undersigned understands and acknowledges that the above marked facility is an alcohol and drug free property managed by NorthStar Regional. The undersigned resides in the capacity of a participant sharing facility space and not as a tenant with rights or possession of space exclusively. Additionally, the participant understands that he\/she waives any landlord\/tenants' rights as outlined under Minnesota Chapters 504B.0001 - 5048.471 and may be discharged at any time for violation of this agreement. The undersigned is responsible for all residential fees during the course of participation.\nThe undersigned participant agrees to be a part of and abide by the policies and rules set by NorthStar Regional The undersigned agrees to vacate the shared accommodation when cardinal, listed rules are violated. The following program policies are to be observed by all participants. These policies have been set forth by NorthStar Regional to maintain a clean, safe, and healthy living environment for those in recovery and to those who are willing and ready to change their lives and transition back into society. Any infraction of these program policies could result in disciplinary action and automatic removal from the facility. The decision to remain a participant is based on each participant's behavior, and our goals are to help each participant attain their goal of self-sufficiency by staying clean and sober and to find employment.<\/div><div id=\"field_6_104\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_104\" ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_6_1\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_1\" ><b>1.\tProgram Fee:<\/b> The program fee is $1135 per month. Participants receive a prompt payment discount down to $625 per month if they pay the program fee by the 5th of the month. After the 5th, there is a late fee of $5 per day, until the 10th . Payment on the 10th or later is not discounted. If a participant moves from the facility under emergency circumstances, prepaid service fees remaining shall be refunded on a pro-rated basis. Any failure by participant to pay fees when due, or failure to comply with any other of the conditions of this agreement allows NorthStar Regional to immediately void this agreement. Any infraction of the program rules may result in the immediate termination of the program agreement and expulsion from the house, and forfeiture of any program fees.<br><br>\n<b>2.\tStandard Curfew: <\/b>All participants who are working will be expected to return to the house by 11:30 p.m. Sunday Thursday and midnight Friday & Saturday. Participants need specific permission to leave any earlier than 5:00 am or work later than 12:00 a.m. Curfews are designed to help our participants change behaviors and learn new skills.<br><br>\n<b>3.\tNew Arrival Curfew: <\/b>All new participants will return to the house by 9:00 p.m. every day. Clients coming to sober housing from NorthStar Regional Residential or Lodging are exempt from this rule and will abide by the standard curfew, see Rule 2. New participants will abide by the Standard Curfew after initial 30-day probationary period. (no passes during probationary period).<br><br>\n<b>4.\tMedication: <\/b>Our facilities do not dispense medication. Our policy prohibits taking mood-altering medications including but not limited to; scheduled drugs, controlled substances, or narcotic medications; however, we understand that circumstances may arise that require such medications. Should this occur, participants may be discharged with a full explanation to any supervisory agency. Any participant sharing or receiving medication will be terminated without question. All medications are subject to accountability check(s) by staff or resident managers. Participants that are found to be abusing medications such as, ingesting dosages other than what is written on the prescription label will be discharged. New prescribed medications must be disclosed to resident manager immediately.<br><br>\n<b>5.\tDrug and Alcohol Use: <\/b>Participation is made available on the strict understanding that the house is to be, at all times, drug, and alcohol free. If a participant uses any illicit drug, consumes alcohol, or ingests prohibited prescription drugs, the participant will be discharged immediately from the program. In addition, guests or visitors of a participant who are under the influence of any type of mind-altering substances are not permitted, at any time, in the house or on the grounds. Protecting and\/or knowing a fellow participant is drinking or using may be cause for immediate dismissal. Reporting all suspicions to resident assistant is an expectation of every participant. Clients can be asked to perform a drug screen\/toxicology test or breathalyzed at any time for any reason.<br><br>\n<b>6.\tHouse Liability: <\/b>NorthStar Regional is not liable for any personal property during or after the participant's discharge from the house. NorthStar Regional will dispose of all personal property 60 days after discharge. NorthStar Regional assumes no responsibility for the personal property of the participant.<br><br>\n<b>7.\tPayment Plans: <\/b>Payment plans will be written for all participants that are $200.00 or more in arrears in program fees\/rent. They will be written by the Housing Coordinator and client together. Once the participant agrees to plan and signs the document, the document will be enforced. Participants in careers will be required to provide all pay stubs from their employer.<br><br>\n<b>8.\tNo loud music: <\/b>Only headphone type radios allowed. Loud and excessive noise disturbs other participants and will not be tolerated. The TV I s will only be played at reasonable volume levels and violation of these rules will be considered disruptive behavior.<br><br>\n<b>9.\tWithout director's written permission, no participant will: <\/b>install paneling, flooring, built in decorations, partitions or railings. Drill or attach anything to the floors, walls, or ceiling of the house, bring in any dish washing, heating, ventilating, air conditioning units, or any water filled furniture.  All personal property not belonging to NorthStar Regional is subject to insurance at participant's expense, hang any shades, blinds and\/or window guards in or outside of the premises, Permit the accumulation of garbage or recycle in the facility or move any furniture unless for cleaning purposes.<br><br>\n<b>10.\tVisitation: <\/b>No visitors are allowed, except for same sex sponsors\/spiritual advisors. Opposite sex visitors and others are only allowed at the property if they are family members and for a maximum of one hour (subject to resident assistant approval). Supervised children are allowed on site for no more than 6 hours and may be asked to leave if there are reports disruption(s). Covid policies for visitation are under NorthStar Regional\u2019s discretion.<br><br>\n<b>11.\tIntimidation and\/or violence: <\/b>Any open or subtle hints of intimidation, violence or profanity towards participants or staff are grounds for immediate termination.<br><br>\n<b>12.\tNo smoking in the house: <\/b>Smoking in designated areas only, must be 10 feet away from any structure.<br><br>\n<b>13.\tNo sexual activity: <\/b>Not on the property.<br><br>\n<b>14.\tHousekeeping: <\/b>Each participant is responsible for washing dishes immediately after eating. Sleeping areas are to be clean at all times. Participants are responsible for cleaning all community living areas. Participant will keep the premises clean at all times, and upon termination will leave the premises in as good of a condition. All participants are assigned and will perform weekly house chores.<br><br>\n<b>15.\tExcessive Utilities: <\/b>Be aware of abusing free utilities. Turn off all lights in rooms not being used. Washers and dryers \tare available for your use. NorthStar Regional will pay all water, gas, heat, light, local telephone service, cable, and power to the house. The last person out of each facility should turn off all lights. Participants are not allowed to have hot plates, heaters, air conditioners, microwaves, small appliances, or large appliances in participant rooms.<br><br>\n<b>16.\tOut of Bounds: <\/b>Participants may not enter another person's room without permission. If there is a roommate in the room, the guest wanting to enter the participant's room must obtain permission from the other roommate as well.<br><br>\n<b>17.\tNo Food Areas: <\/b>Food will be eaten in the dining and upstairs living area only. No food in bedrooms.<br><br>\n<b>18.\tPasses: <\/b>Each participant has access to 5 passes per month. If client is from outside the NorthStar Regional system, a minimum of thirty days in the house is required. Participants are required to fill out a pass request form with a minimum of 48 hours' notice. The resident assistant will approve all passes based on performance in the house. All program fees must be current to be approved. Pass requests exceeding 5 days per month need to be approved in staff meeting.<br><br>\n<b>19.\tWork: <\/b>Within 30 days, all participants are required to volunteer, be enrolled in, and attending school, or work at least 20 hours per week.<br><br>\n<b>20.\tSleeping: <\/b>All participants must be awake, dressed, with areas cleaned by 9:00 am on weekdays. Participants will not sleep in the living room. Lights should be out by midnight on weeknights.<br><br>\n<b>21.\tHouse Activities: <\/b>All participants will participate in any house activities, including business meetings, group sessions, and weekly housekeeping duties. Additional activities, such as speaker meetings, occupational groups and\/or housing network meetings. Mandatory workdays for all participants may be assigned for cleaning duties each month if the house becomes unsanitary.<br><br>\n<b>22.\tMandatory House Meeting Attendance:<\/b> All participants must attend weekly house meetings. This is an important meeting for all participants to attend, unless prior arrangement with staff has been made. If participants are unable to attend, they must leave their AA\/NA meeting attendance card at the house, be caught up on rent, and call to check in with the housing coordinator within 24 hours of the house meeting.<br><br>\n<b>23.\tSober Support Meeting Attendance: <\/b>All participants must attend three outside published 12 step meetings per week. The meeting attendance slips are to be turned in to the resident assistant prior to weekly house meetings.<br><br>\n<b>24.\tLoitering: <\/b>Loitering in cars by visitors and\/or residents outside the facility is not permitted at any time and could be construed as mischievous behavior resulting in discharge.<br><br>\n<b>25.\tSponsorship: <\/b>All participants will be required to obtain a 12-step sponsor\/mentor within 14 days of program participation. We will verify with your sponsor.<br><br>\n<b>26.\tOutpatient Treatment Programs: <\/b>All participants must attend all court, parole\/probation, social services referred treatment plans. Furthermore, clients must follow all discharge recommendations from their treatment programs. NorthStar Regional may request that participants provide discharge\/assessment documentation. Clients enrolled in Outpatient Programs must attend all groups.<br><br>\n<b>27.\tDress Code: <\/b>All participants must be properly attired in the community areas.<br><br>\n<b>28.\tPornography: <\/b>No pornography and sexual aides in the facility.<br><br>\n<b>29.\tNo pets: <\/b>Participants are not permitted to have any pets on the property.<br><br>\n<b>30.\tTelephones: <\/b>NorthStar Regional provides free in-house telephone service. Participants are allowed 10 minutes maximum for each call. Telephone service is a privilege. Any problems with the telephones will result in service being discontinued.<br><br>\n<b>31.\tWeapons: <\/b>No weapons of any kind are allowed on facility property.<br><br>\n<b>32.\tFraternizing: <\/b>Any participant actively enrolled in treatment with NorthStar Regional is prohibited from fraternizing with other active clients. Doing so would risk discharge from both programming and housing.<br><br>\n<b>33.\tNotice to vacate: <\/b>A written thirty (30) day notice of intention to discontinue participation is requested from all participants.<br><br>\n<b>34.\tGrievance: <\/b>If a participant feels that another participant is not doing their share of the chores, or has any other grievances towards another participant, they may call a meeting with the resident assistant with all participants to discuss the grievance. If a participant\u2019s action or behavior is found unsatisfactory by a majority of the participants at such meeting, the participant will be given the opportunity and reasonable time to change their behavior. If, after two such meetings, the offending participant fails to make the necessary changes, the director will be advised, and subject to his discretion, may terminate the program agreement. Complaints; ombudsman for mental health and developmental disabilities. Any complaints about a sober home may be made to and reviewed or investigated by the ombudsman for mental health and development disabilities, pursuant to sections 245.91 and 245.94 Subd.4. <br><br>\n<b>35.\tVehicles: <\/b>To operate and\/or park a motor vehicle while residing at the facility, a valid driver's license, proof of insurance and registration are required. Copies need to be in file at the main office. The vehicle may be towed at your expense. If you own a vehicle and can't legally drive it, park it elsewhere.<br><br>\n<b>36.\tRoom inspections: <\/b>Room inspections may be carried out at any time by the Resident Assistant, which is subject to approval of the Housing Coordinator or other staff. Staff may search participant rooms at any time.<br><br>\n<b>37.\tTheft: <\/b>Any instances of stealing will result in immediate expulsion and be forwarded to police who will make a decision on charges and prosecution. This includes stealing from other peers, taking items from the house\/property. i.e. pillows and linens, that are not yours, and taking food with you that is not yours. Participants being funded by the Housing Support Fund (formerly known as GRH) are not authorized to take any food with them when they leave.<br><br>\n<b>38.\t Bar\/Casino Restriction: <\/b>Clients are not allowed to go to casinos at any time or for any reason. Clients are not allowed to go to a bar unless it is also an eating establishment, and they are there to eat a meal.<br><br>\n<b>39.\tLength of Stay: <\/b>The Maximum length of stay is 9 months. Exceptions made for Resident Assistants. <br><br>\n<b>40.\tReporting Income: <\/b>If a client is being funded by the Housing Support Fund, and you are working, said client has 10 days from the day of receiving income by law to report any income to their financial worker at the county. This pertains to people working for cash or check, as well as people receiving a paycheck from a company. If the client does not report their income, they are subject to discharge and staff will report them to their financial worker.<br><br>\n<b>41.\tTransportation: <\/b>Clients must use med rides from insurance for transportation to and from programming. If ineligible, NorthStar Regional will provide transportation to and from programming only. Clients must call 24 hours in advance to request a ride from NorthStar Regional. If you don\u2019t need the ride, you\u2019ve already scheduled, call and cancel immediately. Failure to follow transportation expectations may result in loss of transportation privilege.<br><br>\n<b>42.\tConsequences: <\/b>The staff of NorthStar Regional reserves the right to enforce the following consequences for infractions of any, or all, of the above house policies. The consequences may include extra chores, behavioral contract, restriction to the house, no passes, or discharge from the program.<br><br><br><\/div><div id=\"field_6_105\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_105\" ><h3 class=\"gsection_title\">Bill of Rights<\/h3><\/div><div id=\"field_6_106\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_106\" >An individual living in a sober home has the right to:<br><br>\n(1) have access to an environment that supports recovery;<br><br>\n(2) have access to an environment that is safe and free from alcohol and other illicit drugs or substances;<br><br>\n(3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms of maltreatment\tcovered\tunder the Vulnerable Adults Act, sections 626.557 to 626.5572;<br><br>\n(4) be treated with dignity and respect and to have personal property treated with respect;<br><br>\n(5) have personal, financial, and medical information kept private and to be advised of the sober home's policies and procedures regarding disclosure of such information;<br><br>\n(6) access, while living in the residence, to other community-based support services as needed;<br><br>\n(7) be referred to appropriate services upon leaving the residence, if necessary;<br><br>\n(8) retain personal property that does not jeopardize safety or health;<br><br>\n(9) assert these rights personally or have them asserted by the individual's representative or by anyone on behalf of the individual without retaliation;<br><br>\n(10) be provided with the name, address, and telephone number of the ombudsman for mental health, substance use disorder, and developmental disabilities and information about the right to file a complaint;<br><br>\n(11) be fully informed of these rights and responsibilities, as well as program policies and procedures;<br><br>\n(12) not be required to perform services for the residence that are not included in the usual expectations for all residents;<br><br>\n(13) Client belongings with be kept for 60 days. (Clients must make an appointment to get their items and will be required to fill out an inventory sheet prior to leaving the house).<br><br><br>\n<\/div><div id=\"field_6_107\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_107\" ><h3 class=\"gsection_title\">Private Right of Action<\/h3><\/div><div id=\"field_6_108\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_108\" >In addition to pursuing other remedies, an individual may bring an action to recover damages caused by a violation of this section.\n\nPlease type or print the following: I HAVE READ AND UNDERSTAND HOUSE POLICIES AND PROGRAM AGREEMENT:\nBy signing or typing your full name below and the last four digits of your Social Security Number, you agree that all information provided is true and accurate to the best of your knowledge. In addition, you agree you understand and will abide by all program policies and may be subject to program discharge for violation of any program policies.<br><\/div><div id=\"field_6_109\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_109\" ><label class='gfield_label gform-field-label' for='input_6_109'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_6_109' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_111\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_111\" ><label class='gfield_label gform-field-label' for='input_6_111'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_111' id='input_6_111' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_6_111_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_6_111_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_6_111' class='gform_hidden' value='https:\/\/northstarregional.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_6_112\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_112\" ><label class='gfield_label gform-field-label' for='input_6_112'>Last 4 of SS#<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_6_112' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_6_141\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_6_141\" >Please note: Incomplete applications will not be considered. In addition, to be placed on waiting lists, a complete program application must be submitted.<\/div><\/div><\/div>\n        <div class='gform_footer top_label'>  \n            <input type='hidden' class='gform_hidden' name='is_submit_6' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='6' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_6' 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'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7d33ce2a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7d33ce2a\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-47cca544\" data-id=\"47cca544\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-39cf9402 elementor-widget elementor-widget-heading\" data-id=\"39cf9402\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Sober Housing Requirements<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1965d2e1 elementor-widget elementor-widget-text-editor\" data-id=\"1965d2e1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tSome of the requirements for Sober Housing include:\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17b5a81b elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"17b5a81b\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3d7208c2 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3d7208c2\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-3533877c\" data-id=\"3533877c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-235062ff elementor-mobile-align-left elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"235062ff\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must be an addict or alcoholic by admission.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Commit to 90 days minimum must give 30 days to vacate.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must be 18 years old or older.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must be at least 30 days sober <span style=\"font-family: &quot;Roboto Slab&quot;, sans-serif; font-size: 17px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 300; white-space: normal;\">with continuous sobriety<\/span>. <\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must work a program of recovery.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-47a03e1e\" data-id=\"47a03e1e\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-146003ce elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"146003ce\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Need prior approval for house arrest. <\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must not have a history of sex crimes or arson.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Acquire a <span style=\"font-family: &quot;Roboto Slab&quot;, sans-serif; font-size: 17px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 300;\">abstinence-based sponsor<\/span> or mentor within 14 days.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must attend a minimum of three abstinence-based support groups (A.A.\/N.A.) per week.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-check\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Must work, volunteer, or go to school in a part-time capacity of at least 20 hours.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2a32d66a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2a32d66a\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7a8432df\" data-id=\"7a8432df\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a350b85 elementor-widget elementor-widget-heading\" data-id=\"1a350b85\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Details<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-53d3f861 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"53d3f861\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f74e846 elementor-widget elementor-widget-heading\" data-id=\"1f74e846\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Additional Information<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-265361b1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"265361b1\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-6bca6816\" data-id=\"6bca6816\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1892ad8 elementor-position-top elementor-widget elementor-widget-image-box\" data-id=\"1892ad8\" data-element_type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img fetchpriority=\"high\" decoding=\"async\" width=\"405\" height=\"300\" src=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-door.png\" class=\"attachment-full size-full wp-image-1447\" alt=\"open door icon\" srcset=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-door.png 405w, https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-door-300x222.png 300w\" sizes=\"(max-width: 405px) 100vw, 405px\" \/><\/figure><div class=\"elementor-image-box-content\"><h3 class=\"elementor-image-box-title\">Rooms<\/h3><p class=\"elementor-image-box-description\">We offer private and semi-private rooms as well as flexible payment plans.<\/p><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-44fa3467\" data-id=\"44fa3467\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cdd1ebe elementor-position-top elementor-widget elementor-widget-image-box\" data-id=\"cdd1ebe\" data-element_type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img decoding=\"async\" width=\"405\" height=\"300\" src=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-minnesota.png\" class=\"attachment-full size-full wp-image-1458\" alt=\"Minnesota state icon centered\" srcset=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-minnesota.png 405w, https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-minnesota-300x222.png 300w\" sizes=\"(max-width: 405px) 100vw, 405px\" \/><\/figure><div class=\"elementor-image-box-content\"><h3 class=\"elementor-image-box-title\">Locations<\/h3><p class=\"elementor-image-box-description\">We currently have sober homes in Minnesota in the following cities: Chaska (5), Carver (1), Chanhassen (1), and Shakopee (3).<\/p><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-ab5a722\" data-id=\"ab5a722\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4614e0ad elementor-position-top elementor-widget elementor-widget-image-box\" data-id=\"4614e0ad\" data-element_type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img decoding=\"async\" width=\"405\" height=\"300\" src=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-wifi.png\" class=\"attachment-full size-full wp-image-1463\" alt=\"wifi icon\" srcset=\"https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-wifi.png 405w, https:\/\/northstarregional.com\/wp-content\/uploads\/2018\/12\/nsr-icons-wifi-300x222.png 300w\" sizes=\"(max-width: 405px) 100vw, 405px\" \/><\/figure><div class=\"elementor-image-box-content\"><h3 class=\"elementor-image-box-title\">Amenities<\/h3><p class=\"elementor-image-box-description\">We provide telephones, cable, wi-fi internet, bedding, laundry facilities, and household supplies.<\/p><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2a0a31f7 elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2a0a31f7\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-72c0040a\" data-id=\"72c0040a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8d293af elementor-widget elementor-widget-heading\" data-id=\"8d293af\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Questions about Applying for Housing?<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e3c3852 elementor-widget elementor-widget-text-editor\" data-id=\"1e3c3852\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\tContact us via the button below, and we\u2019ll be happy to direct you from there.\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34c7a043 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"34c7a043\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/contact\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Contact Us<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-321d1414\" data-id=\"321d1414\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-16b562a7 elementor-widget elementor-widget-image\" data-id=\"16b562a7\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/northstarregional.com\/wp-content\/uploads\/elementor\/thumbs\/Harrison-family-room_couches-LR-pq0lup5ne27wjguu423rtzck61mu3p2yointotm74k.jpg\" title=\"Harrison-family-room_couches-LR\" alt=\"sober housing sitting room\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Application This application is for sober housing, not for housing during treatment. If you need housing while in treatment, please contact us for more information. Application This application is for sober housing, not for housing during treatment. If you need housing while in treatment, please contact us for more information. Getting Started Instructions To apply [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":41,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ocean_post_layout":"full-screen","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"on","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Sober Housing Application | NorthStar Regional | Sober Community<\/title>\n<meta name=\"description\" content=\"This application is for sober housing, not for housing during treatment. 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