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Student Application


 

IHHM Is now accepting applications 

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IHHM is excited to share our facility will be opening soon! If you're interested in applying and are open to working one-on-one until we officially launch, please complete the application on the left.

We are so excited to work with you!

Birthday
Month
Day
Year
Do you have
Are You
Could you be pregnant at this time?
Yes
No
Not Sure
Can you read and write?
Yes
No
Do you have any pending court dates?
Yes
No
Are you currently on probation?
Do you need to detox?
Yes
No
Are you currently using nicotine products?
Yes
No
Do you have any of these medical conditions?
Any Allergies
Have you ever been diagnosed with any of the following
You are required to have a 90-day supply of meds upon admission. Are you able to obtain these before your entry date?
Yes
No
Upon admission, IHHM will ask for a donation of at least $400.00 per month per student.
Agree to the donation price
Need to talk with someone regarding the donation
Cannot afford it at this time
Disclosure: IHHM is not a Medical Facility. If you are due for a doctors checkup or are in needof dental work, we strongly advise that you take care of that before you enter our program. Please state if you understand.
I understand
Need to talk to someone
If IHHM has not opened our facility yet but you would lilke to start now and get a head start please check below and someone will get back to you.
I'd like to go ahead and get started on my new life
Please keep my application and let me know when the facility has opened.
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