Recovery Support Survey

We're looking for some basic info

The Recovery Survey takes 60 seconds

The survey helps us understand you, your relationship to recovery, and your or your loved one's recovery needs. And remember, our services are free. We don't require insurance for our services, but some of our referral partners might, and we can help with getting you set up with Illinois Medicaid if that is one of your needs.

By participating in this survey you consent to the collection and processing of your personal information solely for the purpose of assisting you or a loved one in delivering recovery support services to improve recovery outcomes from drug or alcohol addiction.

Michael Wooten

2 years in Recovery

Contact Information

Please provide your information so we can contact you about your needs and our recovery support services.

 

 

Tyrone "Ty" Hill, Amare Recovery Coach

4 Years in Recovery

Needs

Let's find out your needs for your recovery journey.

How can our recovery staff help with your needs?

*If you are in the Illinois Madison or St. Clair County area, and need financial assistance for sober living, please visit fill out our financial assistance application. Funding is limited.

Alida Barela, Amare Recovery Coach

12 years in recovery

Some Substance History

Answer as honestly as you can.

Let's get some information about substances you may be having challenges with.

Challenging Substances (Check All That Apply) *

Amare's "Riverbend Recovery & Resource Center"

144 E. Ferguson Ave., Suite b., Wood River, IL 62095

Thank You!

Your response and honesty are appreciated. We will be in touch very soon.

After submitting your survey, our team will get back with you as soon as possible.

Some of our recovery staff!