First Baptist Church-Hoxie
Home
About
Our Story
What We Believe
Mission and Vision
Leadership
Contact
I'm New
Connect
Prayer Request
Transportation Request
Children's Church
Worship Jesus
Be a Disciple of Jesus
Serve Jesus
Make Disciples of Jesus
Events
Media
Compassion
Food Pantry Registration
FirstHope Homeless Initiative
Homeless Shelter Registration Form
Give
The Refuge
About Us
Refuge Connect
Need a Meeting?
Daily Accountability Check-in
Recovery Emergency
Event Signup
The Refuge- Daily Accountability Check-in
First Name (Optional)
Last Name (Optional)
Phone/Text Message
Email
Daily Accountability Check-in Checklist
Rate your day so far on a scale of 1-10
1
2
3
4
5
6
7
8
9
10
Have you had any setbacks in your sobriety?
Cravings
Triggers
Refusal
Using
Other
Tell us about it...
How motivated are you to stay sober?
1
2
3
4
5
6
7
8
9
10
Do you have any high risk situation or activities that you have not planned for yet?
Yes
No
Would you like to develop a plan?
Are there any thoughts or feelings you need to share?
Happy
Sad
Anxious
Shame
Craving
Paranoid
Self Confident
Despair
Tired
Lonely
Depressed
Joyful
Successful
Hopeful
Motivated
Loved
Other
Share your thoughts or feelings....
How effective have you been in staying connected to a social support network or group?
1
2
3
4
5
6
7
8
9
10
Share how your social support network or group has or has not helped you today...
Do you need to talk to a Recovery Specialist Representative from the Refuge?
Yes
No
Would you like to share anything else with us?
One day, one hour, one minute, one second... You can live a life of sobriety. We want to help. Praying for you. ~The Refuge
Submit