Emergency: If you or someone else is in immediate danger, call 911. If you’re experiencing a mental health crisis, call or text 988.

Referral

Referral / Interest Form

Use the form to request services, inquire about groups, or ask for more information.

Open the Google Form Back to Home

Before you submit

  • Submitting a form does not guarantee services
  • We review submissions and follow up as appropriate
  • Please include the best way to contact you

Need help?

Email: therhodyhaven@gmail.com

Emergency: call 911. Mental health crisis: call or text 988.

Form link: https://docs.google.com/forms/d/e/1FAIpQLSceCdymTNbUiIPndLX2NL77j777DFnGrg3xulhSpu4Mu4mnqg/viewform?usp=header"footer">

Contact: therhodyhaven@gmail.com