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.

Universal Program Application

To apply for our Clinic, Vocational, Foundations, or Supported Living programs please complete the following:


Assertive Community Treatment

To apply for Assertive Community Treatment (ACT) services, complete the ACT Referral. Referrals should be faxed to 888-525-4231.

ACT Referral

Residential Crisis Services

To apply for Residential Crisis Services, complete the RCS Referral. Referrals can be faxed to 844-762-3230 or emailed to

You can also reach our RCS team by phone at 301-674-9701.

RCS Referral

Residential Rehabilitation Program

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

LBHA RRP Application


For specific questions about Clinic Intake please reach out to our Intake Coordinator at 202-308-7365