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request information and download applications

Applying to the Recovery Education Program requires the completion of an Application Form (PDF) and Medical Referral Form (PDF); both forms are required before your application can be processed.

Both forms must be submitted to apply:

Application Form (PDF)
Medical Referral Form (PDF)

Once you have completed both forms fax or mail them to:

Fax:

(617) 353-7700

Postal:
Center for Psychiatric Rehabilitation
Attn: Elizabeth Brennan
940 Commonwealth Avenue West
Boston, MA 02215

 

If you have any questions or are seeking additional information, please use the form below to submit your inquiry.

Information Request Form
*Denotes a required field. Contact information is required (email, telephone or postal address) if you are requesting correspondence.

*First Name:
*Last Name:
Street Mailing Address:
 
City
State
Zip
Phone Number:
(please include area code)
*Email address:
(ex: dorih@bu.edu)

Please Check all that apply:
I prefer a printed application mailed to above address.
I would like a response to a specific question (below).
I would like to receive the Mental Health & Rehabilitation eCast once a month with special announcements from the Center for Psychiatric Rehabilitation.

If you are reading this site and feeling a need for immediate services please contact your provider or nearest hospital. We do not provide web based crisis management services.

Additional Comments:

We will respond in a timely manner to your request regarding recovery oriented services.

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Contact Us | © Center for Psychiatric Rehabilitation, Trustees of Boston University | Updated March 17, 2011