Contact Information

Your contact and recovery information helps us provide better recovery support.




    What types of recovery support are you currently getting? (please select all that apply.)






    Telephone Recovery Support phone calls are made by trained and open-minded staff and volunteer members. However, if there is a specific group of people you feel more comfortable talking to such as gender and racial group, please describe. Please note that we do our best, however we cannot always honor your requests due to staff and volunteer availability.



    The purpose of the disclosure authorized in this consent it to: provide telephone recovery support. I understand that my alcohol and/or drug treatment records are protected under the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2, and the Health Insurance Portability and Accountability Act of 1996 (HIPPA), 45 C.F.R. Pts. 160& 164 and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at any time. This consent expires automatically as follows:

    1. I grant permission for a staff member or volunteer from ECI to call me at the above phone number and address to support me in my recovery.
    2. Each time the ECI volunteer calls, he/she/they will be asking me how my recovery is progressing and if I am in need of additional support (i.e., meetings in area, recovery community centers, safe/sober housing, social events, and other resources).
    3. At the time of the call, if I am in need of a referral to a treatment program or detox unit, I will be assisted in finding a program, if I so desire.
    4. If at any time I decide not to take part in this program, I will call ECI at 612-564-9289 or tell the volunteer when he/she/they calls

    I authorize Minnesota Recovery Connection (MRC) to place a phone call to me on a weekly basis at the number(s) I provided