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Applications for DMH Services

Applications and forms for DMH services.

Most mental health services, including medication and therapy are provided through health insurance – MassHealth (Medicaid), the Massachusetts Health Connector (health insurance marketplace) or through private insurance (employer-based).  The Department of Mental Health (DMH) provides supplemental services for children, youth and adults with the most serious mental health needs.

For Emergency/Crisis Services: visit the Massachusetts Behavioral Health Partnership (MBHP), or call (877)-382-1609.

For additional resources and information about Mental Health Services in Massachusetts, visit our Mental Health Resources page.

Table of Contents

Contact Info - Where to Submit Your DMH Application

Not sure which office covers your town? Find it here.  Contact your office using the contact information below with questions about the DMH application process. Submit applications 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

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

Fillable Application for DMH Services - can be submitted electronically

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.

Submit this application using DMH Secure Email

Printable applications for DMH Services

Eligibility Information

Most mental health services, including medication and therapy are provided through health insurance – MassHealth (Medicaid), the Massachusetts Health Connector (health insurance marketplace) or through private insurance (employer-based).  The Department of Mental Health (DMH) has a specialized role in the healthcare delivery system.  DMH provides supplemental services for people with the most serious needs.  These services are beyond those supplied through health insurance and require approval by DMH. Learn more about DMH eligibility.

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