Apply for Services
If you have any questions not answered elsewhere on the website regarding our Vocational, Foundations, or Supported Living programs, please call 301-493-4200 x22234 and leave a message. If you have questions for the Clinic please call that location directly. Please note that there may be a waiting list for these programs.
To apply for our Clinic, Vocational, Foundations, or Supported Living programs please complete the following:
Universal Program Application
To apply for Assertive Community Treatment (ACT) services, complete the ACT Referral. Referrals should be faxed to 888-525-4231.
To apply for Residential Crisis Services, complete the RCS Referral. Referrals can be faxed to 844-762-3230 or emailed to firstname.lastname@example.org You can also reach our RCS team by phone at 301-674-9701.
To apply for Residential Rehabilitation Program (RRP) services, complete the Local Behavioral Health Authority’s (LBHA) Application, and return to to:
Montgomery County LBHA
401 Hungerford Dr.
Rockville, MD 20850
FAX - 240-777-1628