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- Outpatient
  - Mental Health
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For Residents
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- Uppers
  - Meth
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Home
About
- Our Story
- The Benefits
- Addiction
- Our Prices
- FAQ
Services
- Sober Living Programs
- Outpatient
  - Mental Health
  - Substance Abuse
For Residents
Locations
Addictions
- Uppers
  - Meth
  - Cocaine
  - Adderall
- Downers
  - Heroin
  - Lean
  - Kratom
  - Ambien
  - Robaxin
- Nicotine
- Alcohol
- Porn
Apply

Sober Living Application

Below you will find our application to apply at Real Deal Sober Living. We are excited to have you! If you have any questions or concerns, please reach out to us at anytime. We look forward to having you join our community.

Name *

First

Last

Email *

Cell Phone *

Address *

Date of Birth (MM/DD/YYYY) *

Social Security Number *

What Treatment Did You Attend? (If None Put None) *

If You Attended Treatment, What Is The Name Of Your Discharge Planner?

What's The Email of Your Discharge Planner?

Are You Planning On Attending IOP/Therapy? *

Yes
No
Not Yet But Interested

How Did You Hear About Us? *

Do you have a pet allergy? *

Which Location Do You Prefer? *

Do You Have A Job? *

When Do You Want to Enter Real Deal? *

Name of Person Financially Responsible *

Cell Phone Number of Person Financially Responsible *

Emergency Contact Name *

Emergency Contact Relation to You? *

Phone Number Of Emergency Contact *

Email of Emergency Contact *

Do You Take Medication? *

Prescribing Physician (Put "none" if you don't take medication) *

Number Of Physician/Physicians Office (Put "none" if you don't take medication) *

If Yes, List Medication Below: *

Ideal Length of Stay *

1-3 Months
3-6 Months
As long as possible

Do You Have Health Insurance? *

Yes
No

If so, What Insurance Carrier? (Put "none" if you don't have insurance) *

Insurance Member ID Number: (Put "none" if you don't have insurance) *

Insurance Group Number: (Put "none" if you don't have insurance) *

Name Of Policy Holder: (Put "none" if you don't have insurance) *

Date Of Birth of Policy Holder (Put "none" if you don't have insurance) *

Do You Have a Pet Allergy? *

Yes
Of Course Not

What's Your Favorite Part of Our Program? *

Exercise Focus
Accountability Focus
Amenities

On A Scale of 1-10, How Excited Are You to Enter Real Deal?

Selected Value: 0

Name

Get Help Now

We are a program of change. However, you must make the first move. We are here for you confidentially 24/7.

Email

Services

Sober Living
Mental Health Outpatient
Substance Abuse Outpatient

Programs

Classic
Classic +
Signature
Trademark

Locations

NE Dallas
Richardson
OG Plano
West Plano
Preston Hollow (Men's)
Dallas Trademark (Men's)
Central Dallas E1 (Women's)
Central Dallas E2 (Women's)
Dallas Trademark (Women's)

About

Our Story
FAQ
Writing For Us
Costs
For Managers

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