Current Families

Visit/Pass Evaluation

Please complete this evaluation each week within 24 hours of the end of your visit/pass.

Parent Reschedule or Absent Request

Use this form to contact leadership staff to request to reschedule or be absent from a regular program commitment.

Teen Satisfaction Survey

At the program's end, residents please complete a satisfaction survey and let us know how this program impacted your family.

Medication Addition/Change Notification Form

This form serves as official notice regarding a requested or recommended addition/change in med procedure for residents of Hope Harbor.

Quarterly Review Form

Submit quarterly review document here.

Request Records

Residents and families, if you need to request a copy of your records please go to the form below:

Pay Tuition

Make a single payment for tuition or set up automatic recurring monthly payments for tuition at this link.

Parent Satisfaction Survey

At the program's end, parents please complete a satisfaction survey and let us know how this program impacted your family.

Publication Release and Permission

At the program's end, residents please complete a satisfaction survey and let us know how this program impacted your family.

GOT MAIL?

WHEN SENDING MAIL TO A RESIDENT, MAIL SHOULD BE ADDRESSED AS FOLLOWS:

Hope Harbor
Resident Name
PO Box
City, State, Zip Code

Privacy Notices

  • Your privacy is important to us, and we desire to protect it. Hope Harbor maintains an opt-in policy for email communications. We only want to send mail to those who have requested participation or with whom we have an ongoing individual or business relationship. Your right to control what mailings, if any, you receive from Hope Harbor is important to us. We may include messages from partners or third parties in mailings, but these will come directly from us and we will not share, sell, or rent your email address.

  • Hope Harbor residents have the right to have information about them kept private. It is our policy to ensure that operations, activities, and affairs of the ministry are kept confidential unless the sharing of information is required by law, ordered by the court of law, required by the licensing body of the organization, or an essential part of the treatment plan or is for the protection of the clients or ministry.

  • Confidential information includes, but is not limited to: information regarding past, current, and future residents and their families, internal reporting, and Hope Harbor’s intellectual property. Release of information to other professionals outside of Hope Harbor may be done only when the parent(s)/guardian sign a release form and only by persons authorized on the release form.

  • (1) Hope Harbor is not a covered entity under HIPAA and is not required to be HIPAA compliant.

    (2) Hope Harbor can request information from HIPAA-covered entities, and covered entities can release that information via fax or ground mail. HIPAA-protected information may not be shared via email.

    (3) Covered entities may also require a signature of their own HIPAA-compliant releases before releasing information.