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1. Complete the Intake Form Below

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Begin by filling out the online intake form with your basic personal information, housing needs, and support history.

2. Eligibility Review

Our staff will review the application to ensure the applicant meets program guidelines. If deemed a good fit for our housing program a non-refundable community fee of $300 is required. Please provide necessary personal information, income verification, and any supporting documentation.

3. Interview and Intake Meeting

Prospective residents may meet with our team to discuss expectations, house rules, and individual needs.

4. Acceptance and Move-In

Once approved, move-in arrangements will be coordinated. Residents will be introduced to the home, house rules, and community resources.

Unpacking Kitchen

500 Terry Francine Street, San Francisco, CA 94158

123-456-7890

Thanks for submitting!

Birthday
Month
Day
Year
Currently Receiving Mental Health or Substance Abuse Treatment?
Desired Move In Date
Month
Day
Year

This form is not monitored 24/7 and is not for emergencies.
If you are in crisis, please call 911 or 988 (Suicide & Crisis Lifeline).

Operating Hours

Mon - Fri

8:00 am – 8:00 pm (EST)

Saturday

9:00 am – 7:00 pm (EST)

​Sunday

9:00 am – 9:00 pm (EST)

Office: 863-362-7610

Text/Secondary Line: 813-669-3933

info@reclaimcommunityprogram.com

We typically respond within 24–48 business hours

Serving, Lakeland FL & Surrounding Areas

 

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