Silver Hill Hospital

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	Join Silver Links Registration Alumni Reunion The Silver Lining

Silver Links Program Registration
Connecting Alumni with New Graduates

Silver Links are Silver Hill Hospital Alumni who have agreed to provide recovery support to new alumni in their home area.

The Silver Hill Alumni Relations Office maintains a database of alumni who are willing and qualified to be Silver Links. Qualified “Links” must be actively working a program of recovery and, for those with addiction disorders, have 6 months or more of sobriety. We match people by gender, age and geography.

First Name
Last Name
Address
City
State
ZIP Code
Home Phone
Email
Discharge Date (MM/YYYY)
Sobriety Date (MM/YYYY)
I attend meetings and can be a contact for:	AA NA Al-Anon NAMI Other (indicate below)
Please indicate other

I hereby give Silver Hill Hospital permission to use the information I have provided in order to contact me about serving as a Silver Link for Silver Hill patients returning to my area.

I understand that:
I can revoke this permission at any time except to the extent that action has been taken in reliance on it. Silver Hill’s Privacy Notice outlines the procedure for revocation. This permission will expire one year from the date I sign it, unless I request an earlier expiration in writing.

By submitting this form, I am authorizing Silver Hill Hospital to give my first name, last initial and phone number to recent alumni of Silver Hill coming to my home area. I understand that I will be contacted by a Silver Hill staff member and given the patient’s first name and last initial.

"My psychiatrist at Silver Hill listened well and was encouraging. I felt part of the process. The entire Treatment Team knew their jobs very well and they were very attuned to the needs of each individual."-Shari S.