Mental Health Services Pre-Screening

Thank you for your interest in our Mental Health Services program! This short pre-screening form helps us better understand your needs and see if you may qualify for our program. Once received, you will receive a response within 2 business days. Your information will be kept private and only used to support your housing application.

If you have any questions, please email mentalhealthservices@pennreach.org or call (609) 802-1702.

    *Indicates required field

    *Email Address

    *What type of services are you requesting? Check all that apply

    (please explain briefly)

    *Are you currently unhoused or in danger of losing your housing?

    *Are you or a member of your household currently employed?

    *Are you or a member of your household a Veteran?

    *Do you have a portable Section 8 or any type of housing voucher?

    If Yes, what agency?

    *Do you need any accessibility features in your unit? Check all that apply

    *Do you have a service animal?

    Is there anything else you'd like us to know? (Optional)

    I confirm that the information provided in this application is true and accurate to the best of my knowledge.
    *Please select "I confirm" to proceed with your pre-screening application.