Pittsburgh Sober Living Application

Please fill out this application to the extent possible. All fields marked with an asterisk (*) are required.  Please note that all deposits are non-refundable.


HIPAA Compliant Statement

Pittsburgh Sober Living strictly follows the guidelines of the Health Insurance Portability and Accountability Act (HIPAA). The contents of your faxed communication are protected by state and federal law. This privileged and confidential information is intended only for use by the Pittsburgh Sober Living staff to fulfill your request.

Pittsburgh Sober Living is committed to your online security. We use SSL technology to securely process your request for information and with our online forms. SSL (Secure Sockets Layer) is an industry standard for encrypting private data sent over the Internet. In other words, we keep your information safe.