Recovery Services Organization Certification Application

The Recovery Services Organization Certification Rule, adopted pursuant to 8 V.S.A § 4089b(f)(2) and 18 V.S.A §§ 102 and 4806, requires that all certified Recovery Services Organizations provide services in accordance with the Certified Recovery Services Organizations: Substance Use Disorder Recovery Standards.

This is the application for the Recovery Services Organization Certification.

Questions can be sent to: [email protected]

Key Roles & Required Information:
The application process involves two key roles:

Applicant/Main Point of Contact – This person will be responsible for completing the application, addressing questions, and providing relevant documentation as needed.
Executive Leadership Representative – This could be an Executive Director, CEO, CFO, COO, or similar role within the organization.

If one person fulfills both roles, you’ll only need to provide their information once. However, if the roles are held by different individuals, kindly share the following details for each:

Name
Job Title
Email Address
Work Phone Number
Mobile Number (optional)

*Please provide your contact information as the Applicant (the person completing this application).

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required. Must be a valid email format: (e.g., [email protected]) This question requires a valid email address.

Work/ Office Phone Number *This question is required. Must be entered in this format: xxx-xxx-xxxx

Mobile Phone (optional) Must be entered in this format: xxx-xxx-xxxx

1. Do you hold the Executive Leadership role?

Please provide the contact information for the Executive Leadership Representative (e.g., Executive Director, CEO, CFO, COO, etc.).

First Name *This question is required.

Last Name *This question is required.

Email address *This question is required. Must be a valid email format: (e.g., [email protected]) This question requires a valid email address.

Work/ Office Phone Number *This question is required. Must be entered in this format: xxx-xxx-xxxx

Mobile Number (optional) Must be entered in this format: xxx-xxx-xxxx