New Resident Application

Tell us a little about yourself.

The form takes about ten minutes. Required fields are marked with an asterisk. Your answers are submitted directly to our team by email — nothing is stored on this website.

About you

Basic contact details so we can reach you about the application.

First name *

Last name *

Date of birth *

Gender identity

Email address *

Cell phone *

Recovery

Desert Haven supports residents actively working on their recovery.

Are you currently in recovery? *

Yes No

Date of last use

Are you in a program?

Yes No

If yes, which program?

Caseworker name

Caseworker phone & extension

Housing

A few details about the move you are planning.

Requested move-in date *

Requested location

How did you hear about DHR?

Referred by

How will you pay rent? *

Work Grant Assistance

Detail

Background

Required for all applicants. Answering honestly helps us place residents well.

Are you a felon? *

Yes No

Nature of conviction

On probation? *

Yes No

Probation officer name & phone

Sex offender? *

Yes No

Nature of conviction

On parole? *

Yes No

Parole officer name & phone

Review & submit

Please review your answers below, sign, and submit. We will reach out to you by email once we have reviewed it.

By signing below, I confirm that I am actively pursuing recovery from substance use disorder. I authorize Desert Haven Residency (DHR) and its staff to conduct a background review and authorize any individual or agency to provide DHR with verbal or written information about me. I agree that a digital image of this authorization is as valid as the original. I understand that my application is subject to DHR approval.

Applicant signature *

Sign above with your mouse or finger

Date applying

Type your name as signature confirmation *

Desert Haven Residency is partnered with independently owned and operated residences serving veterans and adults seeking stable, supportive housing in Tucson.

Application received.

Thank you. We have sent your application to our team at deserthavenresidency@outlook.com. We will reach back out by email within a few business days to talk through next steps.

Back to home · Schedule a call