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This is a pledge between two OA members to support and be accountable to one another. If you think this agreement could be helpful for you, fill out your name and other information as the “I” on one side of the form and have another OA member complete the other half. Cut the forms apart and exchange sides. Place the agreement in a prominent spot to remind you of your commitment to recovery and service.


Recovery Insurance Policy

I, __________ on this day do hereby give __________ __________ (a recovering OA member) permission to take me to a meeting if they do not receive a phone call from me within __________ days of our last conversation, or if they have not seen me at an OA meeting within the last __________ weeks. They have the right to use all means of communication to contact me, including contacting __________ __________ (a friend/relative) for assistance. This agreement may only be terminated after we have had contact and mutually agree to end this agreement.

Signed: __________

Date: __________

My address: __________

__________

__________

My phone numbers: __________

My email: __________

Friend/relative’s phone no.: __________

Always to extend the hand and heart of OA
to all who share my compulsion;
for this I am responsible.


Reprinted from The Twelfth-Step-Within Handbook.
© 2002 by Overeaters Anonymous, Inc. All rights reserved.