ClickCease

Peer Support Employment
Training Application

Peer Support Employment Training Application Form

If you have one of the following AHCCCS insurance plans, the cost of the course will be covered by your insurance: United Healthcare, Health Choice, Mercy Care, Banner University Family Care, AIHP, and Molina. If you do not have one of the listed plans, the out-of-pocket cost for the course is $600.00.

"*" indicates required fields

MM slash DD slash YYYY
MM slash DD slash YYYY
Would You Benefit from a Scholarship?*
Current Address*

Emergency Contact Information

Emergency Contact*

Accessibility Needs

Are there any accessibility needs for you to fully participate in the training? (e.g., service animal, note taker, large text, sign language interpreter)?*

Attestations:

Please check to attest that you meet the following requirements to take the course:
I am at least 18 years of age*
I self-identify as an individual who has lived experience of behavioral health conditions, for which I have sought support.*
I can attest to self-managing and maintaining my own recovery and/or wellness for a minimum of one year.*
I have an experience of recovery to share.*
I have at least 45 days of abstinence from all mind-altering substances, including cannabis.*
I have answered the questions in this application truthfully, and to the best of my ability.*
MM slash DD slash YYYY

Scottsdale Recovery Center, Thrive for Greatness in Your New Found Sobriety.
Trust Arizona’s Treatment Leader, Scottsdale Recovery Center.

Are You Ready for a Lasting Approach to Addiction Treatment?

CALL 602.346.9142

(24/7 Information & Intake)

We are The GOLD Standard in Care with The Joint Commission Accreditation!

The Joint Commission NAADAC NAMI NIH

SRC®’s MISSION Statement

Scottsdale Recovery Center® is a beacon of healing and hope for those who struggle with addiction; offering support and education to their families and a lifeline of services to the community in which they live.

Learn More About Us
Additional Resources

Addiction Info

Specialized Programs

Teleheath Forms

Scottsdale Recovery

8149 N 87th Place,
Scottsdale, AZ 85258

Phone 602.346.9142
Email [email protected]

QualityBBB Safezone Bluecross