Interfaith Recovery Questionnaire

Interfaith Recovery Questionnaire

Foundation for Recovery
Completing this questionnaire is the first step towards having your faith-based organization/congregation Recovery Certified. Becoming Recovery Certified shows members of your organization and community that you have an understanding of the issue and are open to individuals and families impacted by substance use and mental health challenges. Thank you for taking the first step.
Contact Information
Your Name*
Your Email*
example@example.com
Your Phone Number*

Area CodePhone Number
Name of your Organization*
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Name of Pastor, Priest, or Faith Leader - if you are not

First NameLast Name
Website link*
Type N/A if you do not have a website.
Facebook page URL*
Type N/A if you do not have a facebook page.

Pastoral Support
Do you provide pastoral or other faith/spiritual support?*

YesNo
Would you like information on how to incorporate this into your congregation?*

YesNo

Addiction as a Disease
Do members of your faith-based organization view addiction as a treatable disease?*

YesNo
Are you and members of your organization interested in learning more about the brain science of addiction?*

YesNo

Advertising Services
Does your organization/congregation advertise services for those who suffer from Mental Health and/or Substance Use (addiction)?*

YesNo
How does your organization/congregation advertise these services? (check all that apply)*

Bulletin BoardKioskThe PulpitBanners & Signs

Ministerial Programs
What type of ministerial or support programs do you provide to your congregants or the community affected by mental health, addiction, or who are in recovery? (Check All that Apply)*

FeedingRe-EntryHousingTransportationClothingChild CareWe do not provide any ministerial programsAll of the above

Training Topics & Resources
Please select the general training topics or resources you are interested in receiving.*

Suicide PreventionMental HealthOverdose PreventionSubstance Use
Should be Empty:

Contact Information