Apply for Admission

Our admissions process begins with a phone or in-person interview with the applicant. The following forms are required for admission. You can click on the links to download each form:

TREATMENT PROVIDER REFERRAL FORM

This form is to be completed and signed by the current attending outpatient psychiatrist and should include supporting documents such as lab results and psychiatric evaluations. If the applicant is hospitalized, we request full records for the current and all past hospitalizations.

RELEASE OF INFORMATION FORM

This form should be completed, signed and forwarded directly to the Medical Records Department of EACH hospital or agency that has provided psychiatric treatment for the applicant. It may be helpful to hand write at the top of the form, “Please expedite for the purpose of application to a residential program.” This form should also be forwarded to previous private therapists and psychiatrists who have provided treatment.

FINANCIAL AND SERVICE AGREEMENT

As a private program we require this form designating a third-party partnership for financial/logistical support. All applications for admission must include the Financial and Service Agreement form.

FINANCIAL ASSISTANCE APPLICATION

Gould Farm is committed to affordability of residential treatment. Through the generosity of many donors, we extend financial assistance to qualifying families.  To determine eligibility, please complete the Application for Financial Assistance.

NARRATIVE

In addition, we request a narrative from someone in this partnership (usually a parent or sibling) which tells us the story of the applicant’s journey from a non-medical, strength based perspective while fully acknowledging the struggles that have led to application to Gould Farm — the history, the story. The applicant is also invited to write an honest narrative regarding the basis of interest in Gould Farm as a treatment option, and what the applicant hopes to gain in spending some time at Gould Farm. The applicant is encouraged to tell us whatever is most important for us to consider.


NEXT STEPS

Once the application has been reviewed, the applicant and appropriate partnership designee may be invited for an interview in person (whenever possible) or for a phone screening. If all is in order and the match seems appropriate, a two-week evaluation visit is scheduled. At the conclusion of the two week evaluation visit, if Gould Farm is a good fit for all parties, the applicant remains in the program with no disruption.

LIST OF THINGS TO BRING

This is simply a list of suggestions for things to bring once the applicant has been invited for the two-week visit. Begin with the essentials; items can be added as the individual begins to feel increasingly comfortable in the community and discovers what will enhance life at Gould Farm.


At any point in considering Gould Farm as a treatment option, please connect with our Director of Admissions, Tamara McKernan, at 413.528.1804 ext. 32 or admissions@gouldfarm.org.