Take the first step to lasting transformation today by filling out the application below. Once our staff reviews the information provided, we will contact you regarding your next steps.

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PLEASE NOTE:  All incoming clients are required to take a COVID-19 test before entering the program. We are more than willing to assist you in the process if needed. Please call us at 205-324-2271 if you have any questions about testing.

 

JHM Client Application

Step 1 of 6

  • Applicant Information:

  • MM slash DD slash YYYY
  • *This email will be used for general contact needs and is where you will receive a copy of your completed application as well as any necessary follow-up information.
  • Emergency Contact Information:

  • Additional Information:

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