General Memorandum of Understanding
During the year at Nicole’s House, I will be enrolled in and actively participate in a 10 or 12 step, faith-based recovery program, and 1-3 weekly recovery meetings. After admission, I will secure a sponsor, and be assigned a mentor. I give permission for sponsors and mentors to discuss my sobriety and progress in the program with the leadership at Nicole’s House. If a volunteer contradicts NH rules, rules prevail.
I will attend all scheduled in-house meetings/activities/Bible Study.
I will attend the Christian church of my choice at least weekly (to establish fellowship, support & teaching).
I will consent to a medical exam by a doctor or APN asap. I give permission for Nicole’s House to receive medical records and/or discuss my physical and mental health with my care providers. I will provide RX proof and pay for all medications. I am responsible for self-medication and storing said meds in a safe place. I will notify leadership if/when I have medication changes, start or stop taking medications. I will not share medication, and I will not be able to have any RX meds that would present a positive drug result.
Upon admission I will work with volunteers to obtain a birth certificate, social security number, food stamps (to be shared at Nicole’s House), driver’s license reinstatement, ID, and/or medical insurance, etc.
I am responsible for paying (on time) any fines, child support, medical bills, probation and/or parole fees, and the cost of securing a birth certificate, ID or Driver’s license.
I may be asked to surrender my cell phone and refrain from or delete social media for the first 30-90 days of the program., I will erase all contacts that are related to addiction. Once I have a phone, I will surrender my cell phone from 10 p to 6a each day. I will get permission before using house computers and phone. I will not communicate in any way with anyone who is incarcerated. I can make/receive one call per week to family.
If and when I am employed, I will not work more than 24 hours per week; for at least the first nine months of the program, and I will pay $50 per week rent. I will create and abide by a set spending and savings budget.
I will accept and perform all housekeeping, meal prep and kitchen duties. This also includes yard work, taking out the trash, running & unloading the dishwasher, etc. I will handle all appliances responsibly.
I will actively participate 5-10 hours per month in any sustainability or $ raising projects the house may have implemented to generate income for Nicole’s House. I will assist with fund raisers, open houses etc.
I will set goals with the case manager, and consistently work towards achieving those goals. To ensure that I am achieving my goals, I will meet weekly with case management. My financial status may be reviewed monthly. At times, these meetings may also include my mentor, therapist, etc.
I will submit to random drug screens. I will not use drugs or alcohol during my time in the program. Use of drugs or alcohol will result in being discharged from the program, and the house. Suspicion of drug use or theft will result in searches of my bedroom, my person, and personal property.
While here, I become a mandated reporter to the house leadership. I will notify leadership if other residents use drugs, drink alcohol, steal, plan to vacate without notice, destroy property, or become a danger to themselves or others. Failure to do so may result in my termination from Nicole’s House.
Effective October 1, 2019, NH became a non smoking transitional home. If I do smoke, I may be able to vape for 30 days while overcoming the smoking habit. I will supply my own vape materials. I may be asked to hide some piercings or tattoos while at NH. There will be no condemnation for them. I will not get tattoos or piercings while enrolled in this one-year program.
If allowed, family member visits will be at NH for a minimum of the first 90 days. Arrange times with house leadership, so as not to interfere with other house activities. Dating is not permitted. If married, off site conjugal visits may be considered after six months in the program.
I will report my appointments and work schedule on the group calendar. I will sign out when leaving the home and call if there are unexpected changes to my schedule. I will notify leadership if I need transportation. I will abide by the 10 p.m. curfew. I will respond timely to all texts, phone messages.
If I have a vehicle, I will have it properly registered and insured. I am responsible for gasoline and repairs. I will use street parking. I will not abandon vehicles requiring major repair work.
I will practice good hygiene – I will brush my teeth and bathe daily. I will launder clothes, linens and replace bedding each week. I will not flush tampons or pads down the toilet.
I understand that I will share a closet, and I will be respectful of others’ personal items and clothing. NH is not responsible for lost or stolen property. I will be responsible for the cost to repair any damage I incur to the property, furniture, furnishings, etc. I will repay anything that I have stolen..
I will not disclose the physical address of Nicole’s House. Other than DHS, Medial Insurance, my bank, the courts, probation or parole, I will receive mail at: P O Box 44, Avoca, AR. 72711.
In the last quarter of my time here, I will work towards finding my own home
Failure to comply with any of the aforementioned may result in my being terminated from the program and residing in Nicole’s House. I understand that, unless I am here by court order, I am free to leave at any time. However, at this time: I am sincere in my intentions to maintain sobriety; I understand the conditions of the program, and I willingly sign this memorandum of understanding.
Signature Print Name
Witness signature, printed name Date