393 N Dunlap St, Ste #300, St Paul
Meet Our Team
Our Name Change
Mental Health Therapy
Roots Outpatient Treatment
Hennepin County Be@School
Hennepin In-Home Recovery Pilot
View Available Training
Zoom Teletherapy Room Links
Forms & Documents
Pay for Services
Make a Referral
Housing Stipend Update & Payment Request
CLIENT, GROUP & PHASE INFO
Select your counselor here
Select your group here
Current Treatment Phase:
HOUSING PROVIDER & PAYMENT INFO
NOTE: We pay your residence twice per month. You request a payment for the NEXT two weeks, based on the PREVIOUS two weeks' attendance. Example: On the 25th of February, you will request payment for the first half of March based on your attendance the last two weeks of February.
I am requesting payment for the
First Half of
Second Half of
Current Sober Residence:
Move in Date:
MM slash DD slash YYYY
Do you have any plans to move in the next 60 days?
Is any other entity paying for your housing?
Example: GRH, Probation, Foster Care
Who is paying?
Are you currently getting along with your housemates/manager?
Did you attendance all scheduled group and individual sessions during the eligibility period?
Eligibility period example: Payment: March 1-15th: Eligibility Period: Last 2 Full Weeks of February
Did you make up ALL hours missed during the same week you missed them?
How many are you short?
ACKNOWLEDGEMENT OF HOUSING STIPEND TERMS
By checking this box, you indicate that you understand the following terms of the stipend agreement:
1. Eligibility is determined by treatment attendance, and 2 or more weeks of inconsistent attendance may result in your becoming ineligible for the housing incentive.
2. Missing more than two individual counseling session (of any type), may result in your becoming ineligible for the housing incentive.
3. Deductions are made from stipend payments for missed groups that are not made up the same week.
Type Your Name as a Signature Here:
Minnesota CarePartner/Roots Recovery is now
Roots Wellness Center