Application Instructions

  1. The completed application must be signed and submitted below. A copy of this form will be emailed to you once submitted. 
  2. Read and complete the application in its entirety,
  3. Sign the application in every space provided for applicant signature.
  4. Applications that are missing signatures or information will be considered incomplete and will be discarded.
  5. If you have any questions regarding your application, please call us at 256-352-9444 or email us at
  6. Persons with a previous criminal history of violent crimes, sexual crimes or with current outstanding warrants cannot be accepted.

5 Guinns Cove Rd.

Hayden, AL 35079

(256) 352-9444

Royal Pines Recovery Center is a part of Downtown Jimmie Hale Mission, Inc.

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