Recovery Coach Sign-Up Name(Required)Please give us your full nameGender(Required)How do you idenify: Male, Female, Non-Bianary, Other, Prefer not to sayDate of Birth(Required)Month/Day/YearPhone Number(Required)If you do not have a working phone number, please type noneEmailLiving Situation(Required)Please give us your home address or an address where we can send you mailHow can we help?(Required) Making a recovery plan Food Housing Clothing Identification Healthcare Transportation Treatment Replacement Therapy: Suboxon, Methadonee Finding recovery Other basic needs Select AllRecovery Cafe Lexington is not a direct service provider, but we are able to connect members to services and resources. Additional InformationPlease tell us anything else you would to shareCAPTCHA
