Livengrin Alumni Application

Alumni ApplicationLivengrin2019-09-05T12:44:27-04:00

Member Criteria

Livengrin graduate
Active in a recovery program; preferably twelve step
Committed to Livengrin’s mission
Willing to “give back” for patient’s to achieve a clean and sober life

Alumni Application

Alumni Association Application
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Email*
Sobriety Date*
MM slash DD slash YYYY
Dates you were treatment*
MM slash DD slash YYYY
Counselor's Name
How did you hear of Livengrin?*
Explain*
*
- I agree to adhere to the mission and vision of Livengrin Alumni Association.
Name
This field is for validation purposes and should be left unchanged.

Alumni Application

Alumni Association Application
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Email*
Sobriety Date*
MM slash DD slash YYYY
Dates you were treatment*
MM slash DD slash YYYY
Counselor's Name
How did you hear of Livengrin?*
Explain*
*
- I agree to adhere to the mission and vision of Livengrin Alumni Association.
Name
This field is for validation purposes and should be left unchanged.

Livengrin Foundation

4833 Hulmeville Rd.
Bensalem, PA 19020
800.245.4746
alumni@livengrin.org

COVID Safety

During this developing COVID-19 outbreak, Livengrin is committed to protecting our patients, families and staff from the spread of this virus (Coronavirus). As an essential provider of healthcare services, Livengrin plans to remain open and fully operational throughout this emergency. We are taking extraordinary infection-control precautions at all our facilities to maintain a healthy and safe environment. Please contact us with any questions or concerns regarding this situation at info@livengrin.org.