Faith-Based Community Partner Certification Form

A Certified Recovery Congregation is a faith-based congregation, church, or institution and a 

Certified Recovery Community of Faith may include organizations, groups, programs, or entities, that provide recovery support services and/or recovery friendly environments, 

through their identity as a faith-based community partner.

Today's Date*
Which best describes your faith-based service per the provided description?*
A Recovery Congregation is a faith-based congregation, church, or institution and a Recovery Community of Faith may include organizations, groups, programs, or entities, that provide recovery support services and/or recovery friendly environments, through their identity as a faith-based community partner.
Mailing Address*
Physical Address (if different than mailing address)

Type N/A If you do not have a website
Type N/A If you do not have a Facebook page

Pastoral/Spiritual Support

Do you provide pastoral and/or spiritual support?*
Would you like information on how to incorporate this into your congregation/community of faith?*

Addiction As a Disease

Does your congregation/community of faith view addiction as a treatable disease?*
Are you and your congregation/community of faith interested in learning more about the brain science of addiction?*

Advertising Services

Does your Congregation/Community of faith advertise services for individuals with behavioral health challenges?*
How does your congregation/community of faith advertise these services? (Check All that Apply)*

Recovery Meetings

Does your congregation/community of faith host recovery meetings? (Check All that Apply)*
On which day(s) of the week do you host Faith-Based Recovery Meetings? (Check All that Apply)*
On which day(s) of the week do you host Alcoholics Anonymous Meetings? (Check All that Apply)*
On which day(s) of the week do you host Narcotics Anonymous Meetings? (Check All that Apply)*
On which day(s) of the week do you host Other 12-Step Recovery Meetings? (Check All that Apply)*
On which day(s) of the week do you host Celebrate Recovery Meetings? (Check All that Apply)*
On which day(s) of the week do you host Other Meetings? (Check All that Apply)
Does your congregation/community of faith refer individuals to other recovery meetings? (Check All that Apply)*
Are you interested in learning how to host recovery meetings or refer individuals to meetings in your area?*

Ministerial Programs

What type of Ministerial Programs do you provide to individuals beginning or maintaining their Recovery Journey? (Check All that Apply)*
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