Apply for DMH Services

Interested in applying for DMH services? Follow the instructions on this page.
Within seven (7) days of receipt of a Request for DMH Services application, DMH will contact the applicant, parent, or guardian by telephone.

DMH Application Questions

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.

Office

Mailing Address

Phone Number

Fax Number

E-mail Address

Boston

85 East Newton Street

Boston, MA 02118

(617) 626-9200

(617) 626-9216

MBA.serviceauthapplications@mass.gov

Brockton

165 Quincy Street,

Brockton, MA 02302

(508) 897-2000

(508) 897-2047

SEA.serviceauthapplications@mass.gov

Northampton

1 Prince Street

Northampton, MA 01060

(413) 587-6200

(413) 587-6240

WMA.serviceauthapplications@mass.gov

Tewksbury

P.O. Box 387

Tewksbury, MA 01876-0387

(978) 863-5000

(978) 863-5091

NEA.serviceauthapplications@mass.gov

Worcester

361 Plantation Street

Worcester, MA 01605

(774) 420-3140

(774) 420-3165

CMA.serviceauthapplications@mass.gov

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

MBA.serviceauthapplications@mass.gov

Brockton

165 Quincy Street,

Brockton, MA 02302

(508) 897-2000

(508) 897-2047

SEA.serviceauthapplications@mass.gov

Northampton

1 Prince Street

Northampton, MA 01060

(413) 587-6200

(413) 587-6240

WMA.serviceauthapplications@mass.gov

Tewksbury

P.O. Box 387

Tewksbury, MA 01876-0387

(978) 863-5000

(978) 863-5091

NEA.serviceauthapplications@mass.gov

Worcester

361 Plantation Street

Worcester, MA 01605

(774) 420-3140

(774) 420-3165

CMA.serviceauthapplications@mass.gov

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

MBA.serviceauthapplications@mass.gov

Brockton

165 Quincy Street,

Brockton, MA 02302

(508) 897-2000

(508) 897-2047

SEA.serviceauthapplications@mass.gov

Northampton

1 Prince Street

Northampton, MA 01060

(413) 587-6200

(413) 587-6240

WMA.serviceauthapplications@mass.gov

Tewksbury

P.O. Box 387

Tewksbury, MA 01876-0387

(978) 863-5000

(978) 863-5091

NEA.serviceauthapplications@mass.gov

Worcester

361 Plantation Street

Worcester, MA 01605

(774) 420-3140

(774) 420-3165

CMA.serviceauthapplications@mass.gov

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

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