Stuch. Sobriety Consulting — Real People. Real Experiences. Real Change.

Client Application
Take The First Step

Tell us a little about yourself and what you're looking for. Your answers will help determine if STUCH. Sobriety Consulting is the right fit for you.

[ 01 ]Contact Information

Let's get started

Full Name *

Phone Number *

Email Address *

City / State *

[ 02 ]Your Background

Help us get to know you

1. What best describes you? *

Currently in recoveryStruggling and looking for helpSober and want additional supportFamily member / loved oneEmployer / referring someoneOther

2. How long have you been in recovery? *

Just startingLess than 1 year1 – 3 years3 – 5 years5+ yearsNot in recovery yet

3. What substances are you or were you struggling with? (Select all that apply)

AlcoholOpioidsPrescription medicationStimulants (cocaine, meth, etc.)MarijuanaOther

[ 03 ]Your Goals

What do you want to achieve?

4. What areas would you like support with? (Select all that apply) *

Staying sober / relapse preventionAccountabilityBuilding structure and routineMental health / mindsetRelationships / familyEmployment / careerLegal issuesLife purpose and directionOther

5. What is your biggest challenge right now? *

6. What are your top 3 goals? *

[ 04 ]Coaching Preferences

Let's find the right fit

7. What type of support are you interested in? *

One-on-one consultingVirtual coachingIn-person coachingGroup supportFamily support / intervention guidanceNot sure — recommend the best option

8. How soon are you looking to get started? *

ImmediatelyWithin 30 days1 – 3 months3 – 6 monthsJust exploring options

9. How did you hear about us? *

WebsiteSocial mediaReferral (please specify)Other

[ 05 ]Final Notes

Tell us anything else

10. Is there anything else you'd like Scott to know before your consultation?

No judgment. No pressure. Just real people, real support, and a path to a better you.