Relapse Protocol contract:
Check everything below that you are willing to do in order to stay in treatment and stay sober
 Address your peers in the community and apologize
 Get a white key tag/desire chip
 Share at a meeting about what happened and ask for help/suggestions
 Get a sponsor (if you don’t have one)
 Inform your sponsor of what happened (if you do have one)
 Inform family and/or friends outside of treatment
 Ask two peers and one staff member where they think you can improve and what you were
doing wrong.
 Find your new clean date. Write it here:
Clients name:
Clients signature:
Date: