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Ready for My Recovery Form

This form is confidential.

Before submitting this form, you must complete your Health Risk Assessment Screening in order to be eligible for the Ready for My Recovery rewards** program. Submit your completed form and receive a My Recovery Journey backpack** filled with items and resources to support you in your recovery from substance misuse (excluding tobacco/nicotine use).

* Required Field

Have you recently used substances (other than tobacco/nicotine) but are ready to take the first step in your recovery?

If you need immediate assistance with substance use, please call 2-1-1.

Note: Tobacco/nicotine use are not included as part of this program.

**Some restrictions and limitations apply. Each member can earn up to $250 in cash and non-cash goods and services through June 30 each year.