Sober Housing Change – Minnesota CarePartner

Please make note that Roots may not approve payment to a new sober house if you have not spoken to your counselor before making this change, or if you have not notified us of the change in a timely manner.

Sober House Change

Name*
First Last
Group*
Check all that apply
- I moved into sober living
- I moved out of sober living
- I switched sober houses
I confirm that I have discussed this change with my primary counselor*
- Yes
- No
Date of move out (if applicable)
MM slash DD slash YYYY
Date of move in (if applicable)
MM slash DD slash YYYY
Former Sober House (if applicable)
Current Sober House (if applicable)
Is there anything else you need us to know?
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