Dallas–Fort Worth • Faith‑Centered • Serving Ages 16–24 & Families

Welcome to Christ Centered Sober Living

We’re honored to walk with you.

Thank you for taking this important step. Your payment has been received, and you’re now ready to begin the onboarding process. This page will guide you through the forms and resources we need to get started.

Step 1: Complete Your Digital Intake Form

This form gives us the essential background information we need to serve you well. Please fill it out as honestly and completely as possible. Everything you share is kept private and secure.

Individual - Information

First Name *

Last Name *

Preferred Name

Age Range *

Date of birth *

Gender *

Phone *

Email *

Current Grade / Education Status *

Employment Status *

Guardian / Emergency Contact

Parent / Guardian Full Name 1 *

Parent / Guardian Relation 1 *

Parent / Guardian Phone 1 *

Parent / Guardian Email 1 *

Parent/ Guardian Full Name 2 (Optional)

Parent / Guardian Relation 2

Parent / Guardian Phone 2

Parent / Guardian Email 2

Financial Responsible Party

Financial Responsible Party Name *

Financial Responsible Party Relationship *

Financial Responsible Party Phone *

Financial Responsible Party Email *

Substance Use History

What substance(s) have you struggled with? *

How long has this been an issue for you? *

Are you currently sober? If yes, since when? *

Have you previously attended treatment (rehab, outpatient, sober living)? If yes, please list programs and dates: *

Any hospitalizations, legal trouble, or interventions in the past? If yes, please describe. *

Medical & Mental Health History

Do you have any medical diagnoses or physical health concerns? *

Do you take any prescribed medications? *

Have you been diagnosed with any mental health conditions? (e.g., depression, anxiety, ADHD) *

Are you currently in therapy or counseling? *

Faith & Spiritual Background

Do you have a faith or spiritual background? If so, please give a brief description. *

How would you like to see Christian mentorship be part of this coaching? *

Do you currently attend a church or faith community? *

How open are you to prayer, devotionals, or spiritual accountability? *

Goals for Coaching

What would success look like for you at the end of 90 days? *

What do you want to change the most right now? *

What do you want your relationship with your family to look like? *

Communication & Commitment

How would you like to receive check-ins? (Text, Call, Email) * May select more than one. *

Time of Day *

Morning

Afternoon

Evenings

Are you willing to fully participate in coaching, including honest check-ins and completing action steps? *

Documents to Consent

I have read and agree to the following documents: (Click documents below to open in a new tab) *

Yes

• Confidentiality Agreement

• Crisis Emergency Protocol Acknowledgement

• Consent for Faith-Based Services

• Cancellation Refund Policy Agreement

• Liability Waiver

• Client Code of Conduct

• Recovery Coaching Agreement

• Progress Summary Consent Form

Signature

By signing below, I acknowledge that I am voluntarily participating in this coaching program and understand it is not a substitute for medical or psychiatric care. I have read and agree to the documents listed under "Documents to Consent".

Intake Signature *

Clear

Date

Step 2: Review and Sign Paperwork

Here you’ll find agreements and documents that set expectations for the program.

Recovery Coaching Agreement

Client Code of Conduct

Confidentiality Agreement

Cancellation/Refund Policy

Consent for Faith-Based Services

Crisis Emergency Protocol Acknowledgment

Liability Waiver

Progress Summary Consent Form

Access Paperwork →

Step 3: Prepare for Your First Session

To help you feel prepared, we’ve included resources you can review before your first coaching call:

Welcome Guide (what to expect in your program)

Family Support Overview (how parents and loved ones can be involved)

Quick FAQ (common questions about scheduling, calls, and communication)

Need Help?

If you have any questions while filling out forms or preparing, we’re here to help.
📧 Email: [email protected]
📞 Call/Text: (214) 519-9444

You’ve already made one of the hardest decisions: to step forward. From here, we’ll walk together with structure, accountability, and biblical encouragement.

Important Note

At Christ Centered Sober Living, we believe no one should walk this road alone. We’re honored you’ve taken this step, and we look forward to connecting with you soon.

If your need is urgent, please don’t wait. Call or text us directly at 214-727-6002.

For emergencies, dial 911. For immediate mental health support, call 988 (Suicide & Crisis Lifeline).

Christ-Centered Sober Living Coaching exists to walk alongside young adults and families with biblical truth, accountability, and encouragement. Our mission is to provide hope and structure that honors God in the recovery journey.

Age Policy: Our core programs focus on ages 16–24. We also consider coaching for clients outside this range when appropriate. Readiness to engage, safety, and family support (for minors) are required. Christ Centered Sober Living provides faith-based coaching, not medical treatment.

Christ-Centered Sober Living Coaching provides faith-based coaching and support. We are not a medical or treatment facility.

If you or someone you love is in immediate crisis, please dial 911 or contact the Suicide & Crisis Lifeline at 988.

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