The Kane House: Sober Living in Dover, NH | Southeastern New Hampshire Services

The Kane House is a structured. substance-free community in the greater Dover, NH area for men in recovery from alcoholism and/or substance use disorder. The Kane House is not a facility. Our residents interact as members of a large, supportive family in which each individual is valued and respected. Our home offers the safety, structure, and peer mentoring that fosters growth through the early steps of recovery.

15 male-only beds
Conveniently located in Dover, NH (along COAST Bus route) and approximately a 5-minute drive to the city’s downtown area
Located adjacent to Southeastern NH Services, a provider of outpatient services for residents who need additional support

Interested in becoming a resident? Please apply below or call/email Trina Reilley at 603.516.8160 / treilley@co.strafford.nh.us.

I WOULD LIKE TO BECOME A KANE HOUSE RESIDENT

Kane House Application

Basic Information

Name(Required)

First Last

Current Address (if none, indicate "N/A")(Required)

Address Address Line 2 City State ZIP

Date of Birth(Required)

Date of Birth

Phone(Required)

Phone

Email(Required)

Referral Source (Where did you hear about us?)(Required)

Referral Source (Where did you hear about us?)

Do you currently have a case manager?(Required)

Case Manager Name

Case Manager Phone Number

Move-in Date Desired(Required)

Move-in Date Desired

Emergency Contact(Required)

Emergency Contact

First Last

Emergency Contact Relation to Self(Required)

Emergency Contact Relation to Self

Emergency Contact Number(Required)

Emergency Contact Number

Recovery History

Drug(s) of Choice (Please list all)(Required)

Drug(s) of Choice (Please list all)

Length of Current Sobriety(Required)

Length of Current Sobriety

Prior Treatment (Detox/Residential/Inpatient)(Required)

Prior Treatment (Detox/Residential/Inpatient)

Current Treatment Plan (if applicable)(Required)

Current Treatment Plan (if applicable)

Current Medications (include MAT)(Required)

Current Medications (include MAT)

History of Self-harm / Suicidal Ideation?(Required)

History of Self-harm / Suicidal Ideation?

Parental Status(Required)

Parental Status

Relationship Status(Required)

Relationship Status

Do you have support from family?(Required)

Do you have support from family?

If employed, who is your current employer?(Required)

If employed, who is your current employer?

Other sources of income (e.g., alimony, SSI, disability, other)(Required)

Other sources of income (e.g., alimony, SSI, disability, other)

Do you own a vehicle?(Required)

Do you own a vehicle?

Make/Model

License Plate Number

Legal History

Please describe your history of arrests, if applicable.(Required)

Please describe your history of arrests, if applicable.

Have you ever been convicted of a violent or sexual crime?(Required)

Have you ever been convicted of a violent or sexual crime?

Are you currently awaiting charges, trial, or sentencing?(Required)

Are you currently awaiting charges, trial, or sentencing?

Do you have any outstanding warrants in NH or elsewhere?(Required)

Are you on parole?(Required)

Are you currently awaiting charges, trial, or sentencing?

Are you on probation?(Required)

Are you on probation?

Name and Contact of Parole/Probation Officer

Recovery Plan

Are you currently seeing a licensed counselor?(Required)

Are you currently seeing a licensed counselor?

Name / Contact # for Provider

What would you like to accomplish during your stay here?(Required)

What would you like to accomplish during your stay here?

What are your top 3 goals for the next year?(Required)

What are your top 3 goals for the next year?

What is your preferred pathway to recovery (12‐Step, SMART Recovery, etc.) and how will you continue on that pathway while living here?(Required)

What is your preferred pathway to recovery (12‐Step, SMART Recovery, etc.) and how will you continue on that pathway while living here?

What potential challenges do you see in improving your recovery?(Required)

What potential challenges do you see in improving your recovery?

What else would be helpful for us to know about you?(Required)

What else would be helpful for us to know about you?

I WOULD LIKE TO BECOME A KANE HOUSE RESIDENT

Kane House Application

Basic Information

Recovery History

Legal History

Recovery Plan

SUPPORT SENHS /
GIVING INFORMATION

MAKE SOMEONE'S RECOVERY JOURNEY POSSIBLE

KEEP UP WITH SENHS /
NEWSLETTER

SUCCESS STORIES + EVENTS + THE LATEST RECOVERY NEWS.

KEEP UP TO DATE WITH

Southeastern New Hampshire Services

Hear recovery storIes + learn about resources + GET THE LATEST NEWS FROM OUR FAMILY TO YOURS.

I WOULD LIKE TO BECOME A KANE HOUSE RESIDENT

Kane House Application

Basic Information

Recovery History

Legal History

Recovery Plan

SUPPORT SENHS / GIVING INFORMATION

MAKE SOMEONE'S RECOVERY JOURNEY POSSIBLE

KEEP UP WITH SENHS / NEWSLETTER

SUCCESS STORIES + EVENTS + THE LATEST RECOVERY NEWS.

KEEP UP TO DATE WITH

Southeastern New Hampshire Services

Hear recovery storIes + learn about resources + GET THE LATEST NEWS FROM OUR FAMILY TO YOURS.

SUPPORT SENHS /
GIVING INFORMATION

KEEP UP WITH SENHS /
NEWSLETTER