Referral Form Instructions

How to Refer a Resident

If you’re a probation officer, social worker, or family member, you can refer someone by:

  1. Downloading and completing the referral form below

  2. Emailing it to [intake@michaelsheartorg.org]

  3. Waiting for confirmation from our intake team within 1–2 business days

We’ll then schedule a phone interview and verify eligibility.

Eligibility:

  • Male, 18+

  • Committed to sobriety

  • Willing to follow house rules and attend meetings

  • No active warrants or violent charges

Online Intake Form

Instructions:
Please fill out the form below. Someone from our intake team will contact you within 1–2 business days.