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You Don't Have to Start Over Alone

Image by Peggy Sue Zinn

If you're leaving incarceration or finishing detox and aren't sure where to go next, Dottie's Refuge is here for you. We are a Christ-centered transitional home for women, with room for up to six residents at a time. There is no cost to enter the program. In Phase One, you'll have a safe place to live, meals, and caring support while you focus on healing and recovery. In Phase Two, we'll help you find and keep a job as you work toward standing on your own. You don't have to have it all figured out, and you don't have to do this alone. To take the first step, please fill out the resident application below. We'll review it and contact you to talk about next steps. If you have questions, call us at 812.318.5288.

Dottie’s Refuge Transitional Home for Women
Pre-Screening Application

Please complete this application to the best of your ability. You may leave blank any question you prefer to discuss during the follow-up conversation. This information helps Dottie’s Refuge determine whether our program can appropriately and safely support your housing and recovery needs.


Information shared through this application will be treated with respect and confidentiality. It will be used only to support application review, care coordination, safety planning, and program placement considerations.

Applicant Information
Birthday
Month
Day
Year
Emergency Contact
Legal History and Current Court Involvement
Have you ever had a criminal conviction?
No
Yes
Do you currently have any pending charges, warrants, or upcoming court dates?
No
Yes
Probation, Parole, or Court Supervision
Are you currently on probation, parole, home detention, or court supervision?
No
Yes

Court, probation, parole, or supervision requirements that may affect scheduling, housing placement, safety planning, or participation

Recovery and Treatment Information

Primary substance or recovery concern, if applicable: 

Have you been through a recovery / treatment program?
No (skip to next section)
Yes (complete this section)
Date of last use
Month
Day
Year
Are you currently connected with recovery support services?
No
Yes
Health and Reintegration Support Needs
Please check any areas where support may be helpful.
Program Acknowledgements

  • I understand that submitting this application does not guarantee acceptance into Dottie’s Refuge Transitional Home for Women.

  • I understand that a follow-up assessment may be required before a final decision is made.

  • I confirm that the information I have provided is accurate and complete to the best of my knowledge at this time.

  • I understand that Dottie’s Refuge may contact me to clarify or complete information needed for application review and support planning.

  • I authorize Dottie’s Refuge Transitional Home for Women to contact the providers, officers, or emergency contacts I have listed as needed for application review, care coordination, safety planning, or program support.

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