- This page, Apply for DMH Services, is offered by
- Massachusetts Department of Mental Health
Apply for DMH Services
Contacts
DMH Application Questions
Phone
This voicemail box is checked regularly Monday through Friday between 9am and 5pm
Online
The Details of Apply for DMH Services
What you need for Apply for DMH Services
Please Note: In order to simplify the application process, DMH now has a single application form for for all applicants, regardless of their age.
For Emergency/Crisis Services - Call 1-(877) 382-1609 or Visit the Massachusetts Behavioral Health Partnership (MBHP)
Individuals who request mental health services through DMH must submit the following completed forms, with signatures and dates where indicated. These forms are available for download at the bottom of the page:
- Request for DMH Services application.
- Authorization(s) for Release of Information (included in the application packet)
Although additional information is not required at the time of a request for services, DMH encourages applicants to submit available medical/psychiatric information. It is strongly recommended the information be submitted at the same time as the application to expedite the determination process. Such additional information includes:
- Outpatient psychiatric records and testing, and
- Hospital admission and discharge reports.
How to apply Apply for DMH Services
You can apply in person at your nearest DMH site office. To find the office that serves your community, you can search and click your town on our alphabetic index.
This fillable application can be completed and submitted via email without printing or scanning. Email the completed application and related forms to the office covering your town on the table above.
- Download the application.
- Complete the fillable application on your computer
- Submit this application to the appropriate office on the table below using DMH Secure Email
Office |
Mailing Address |
Phone Number |
Fax Number |
E-mail Address |
Boston |
85 East Newton Street Boston, MA 02118 |
(617) 626-9200 |
(617) 626-9216 |
|
Brockton |
165 Quincy Street, Brockton, MA 02302 |
(508) 897-2000 |
(508) 897-2047 |
|
Northampton |
1 Prince Street Northampton, MA 01060 |
(413) 587-6200 |
(413) 587-6240 |
|
Tewksbury |
P.O. Box 387 Tewksbury, MA 01876-0387 |
(978) 863-5000 |
(978) 863-5091 |
Under 18: NEA.CYFServiceAuthRequest@mass.gov 18 & Older: NEA.serviceauthapplications@mass.gov |
Worcester |
361 Plantation Street Worcester, MA 01605 |
(774) 420-3140 |
(774) 420-3165 |
To apply by mail, print and complete the following forms:
- Request for DMH Services application.
- Authorization(s) for Release of Information (see page 8)
When you have completed and signed the forms above, find your city or town on the alphabetic list, and send your application to the respective DMH Office in the list below. Please call the number listed if you have any questions.
Office |
Mailing Address |
Phone Number |
Fax Number |
E-mail Address |
Boston |
85 East Newton Street Boston, MA 02118 |
(617) 626-9200 |
(617) 626-9216 |
|
Brockton |
165 Quincy Street, Brockton, MA 02302 |
(508) 897-2000 |
(508) 897-2047 |
|
Northampton |
1 Prince Street Northampton, MA 01060 |
(413) 587-6200 |
(413) 587-6240 |
|
Tewksbury |
P.O. Box 387 Tewksbury, MA 01876-0387 |
(978) 863-5000 |
(978) 863-5091 |
Under 18: NEA.CYFServiceAuthRequest@mass.gov 18 & Older: NEA.serviceauthapplications@mass.gov |
Worcester |
361 Plantation Street Worcester, MA 01605 |
(774) 420-3140 |
(774) 420-3165 |
To apply by fax, print and complete the following forms:
- Request for DMH Services application.
- Authorization(s) for Release of Information (see page 8)
When you have completed and signed the forms above, find your city or town on the alphabetic list, and fax your application to the fax number for the respective DMH Office in the list below. Please call the phone number listed if you have any questions.
Office |
Mailing Address |
Phone Number |
Fax Number |
E-mail Address |
Boston |
85 East Newton Street Boston, MA 02118 |
(617) 626-9200 |
(617) 626-9216 |
|
Brockton |
165 Quincy Street, Brockton, MA 02302 |
(508) 897-2000 |
(508) 897-2047 |
|
Northampton |
1 Prince Street Northampton, MA 01060 |
(413) 587-6200 |
(413) 587-6240 |
|
Tewksbury |
P.O. Box 387 Tewksbury, MA 01876-0387 |
(978) 863-5000 |
(978) 863-5091 |
Under 18: NEA.CYFServiceAuthRequest@mass.gov 18 & Older: NEA.serviceauthapplications@mass.gov |
Worcester |
361 Plantation Street Worcester, MA 01605 |
(774) 420-3140 |
(774) 420-3165 |
Next steps for Apply for DMH Services
What to expect after you submit your application?
Within seven (7) days of receipt of a Request for DMH Services application, DMH will contact the applicant or guardian by telephone. The purpose of the phone contact will be to:
- Acknowledge DMH’s receipt of the Request for DMH Services application,
- Review the determination process,
- Confirm the applicant or guardian wants to continue the determination process,
- Assess the applicant’s immediate or emerging needs and respond as appropriate, and
- Initiate the collection of relevant medical and other information that supports the applicant’s request for services.
Contact for Apply for DMH Services
Phone
This voicemail box is checked regularly Monday through Friday between 9am and 5pm