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Everyone deserves a home

The Red Road Lodge is a safe, abstinence-based facility for you to live during your path to recovery, healing and stabilization. Our program-based living environment requires your active participation in our life skills mentoring sessions, art and creativity workshops, group information sessions, and relapse prevention programs. All participants are expected to participate in these services and programs as they are provided.

Please note that we do not fall under the jurisdiction of the Residential Tenancies Branch. Therefore, individuals that are not compliant with our requirements may be discharged from our program.

Applicant's First Name(Required)

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Applicant's Last Name(Required)

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Email(Required)

Date of birth

CURRENT ADDRESS

Apartment #

Street

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Postal code

CITY/TOWN

City

LAST PLACE OF RESIDENCE

Apartment #

Street

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Postal code

CITY/TOWN

City

Have you ever been evicted?

If yes, reason for eviction(Required)

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Date that your residency is required(Required)

PLEASE PROVIDE YOUR CURRENT IDENTIFICATION INFORMATION.

I can confirm that I have the following:(Required)

Birth Certificate

Driver's License

Manitoba Health Card

Photo ID

S.I.N.

Treaty Card

Have you ever had a disability case file?

Your current means of support(Required)

E.I.A.

E.I.A. Disability

C.P.P.

Pension

Case Worker's Name

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Phone

Apartment #

Street

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MEDICAL HISTORY

Have you been diagnosed with any medical conditions?

If yes, please explain(Required)

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Do you have a Family Doctor?

Doctor's Name(Required)

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Office Address (#)(Required)

Street(Required)

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Postal code(Required)

Do you require any assistance accessing health services?

If yes, please explain(Required)

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Have you ever been diagnosed with a mental health condition?

If yes, please explain(Required)

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Name(s)(Required)

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Unit Address (#)(Required)

Street(Required)

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Psychiatrist Name(s)(Required)

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Office Address (#)(Required)

Street(Required)

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ADDITIONAL HISTORY

The Red Road Lodge operates as a dry facility and supports sobriety, addictions recovery and addictions treatment.
Alcohol, non-prescription drugs and solvents are forbidden on Red Road Lodge property. This applies to both residents and guests.

When was your last use of any substance(s)?

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How long have you remained clean and sober in the past?

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How did you succeed on that/those occasion(s)?

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Have you ever attended a detox facility?

If yes, where?(Required)

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When?(Required)

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Have you ever attended any treatment program(s)?

i.e. AA, NA, AFM, BFH, Anchorage, MSP, etc.

If yes, where?(Required)

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When?(Required)

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What was the length of the program?(Required)

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Do you currently have a court order prohibiting you from using alcohol/drugs?

Are your currently on a methadone program?

Are you willing to attend AA meetings held at Red Road Lodge?

Are you currently attending any program(s)?

All residents must agree to participate in, and fully cooperate with periodic room visits and workshops. The Red Road Lodge provides life-skill programming to teach individuals the necessary skills to maintain successful tenancy and independent life.
I understand that failure to meet the Red Road Lodge Program requirements will be grounds for discharge and eviction from Red Road Lodge.

I will participate in relapse prevention programs and planning (initial)(Required)

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I will cooperate with weekly life-skills mentoring, which includes room inspections (initial)(Required)

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I agree to contribute a minimum of two hours of volunteer service to Red Road Lodge per week (initial)(Required)

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In what ways do you think you might be able to help? (Check all those that apply)

Art Projects

Cleaning

Clothing

Cooking/Meal Preparation

Personal Hygiene

Relapse Prevention & Mentorship

Winnipeg Harvest Pick up/Storage/Handling

Other

What types of hobbies or activities do you enjoy?

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Homes, Hope, Help, Healing Headlines are Best!

Everyone deserves a home

CURRENT ADDRESS

LAST PLACE OF RESIDENCE

PLEASE PROVIDE YOUR CURRENT IDENTIFICATION INFORMATION.

MEDICAL HISTORY

ADDITIONAL HISTORY

Contact Us

Red Road Lodge

Phone:

Fax:

Email:

Office Hours

Programs

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