APPLY FOR ADMISSION
Choosing a residential mental health program is an important decision. A prospective resident, family member, or treatment provider can contact our admissions team to initiate the process. Our staff is here to answer questions, and assist you through admission. Our process includes gathering information on the potential resident’s past history and determining if Gould Farm is an appropriate fit and best treatment option.
During the first phone call or email conversation, our team members will share information about our program, answer questions, and learn more about the individual seeking treatment. If Gould Farm seems to be a good fit, our team will recommend that the admissions forms be filled out by the potential resident and/or their family, and the referring clinician. Records and discharge summaries from past psychiatric treatment, hospitals or other residential programs are also needed.
During the admissions process the applicant and family may be invited to visit the farm for a tour/interview. Once we have received all the forms and paperwork, a two-week evaluation stay is scheduled. At the conclusion of the two-week evaluation stay, if Gould Farm is a good fit the admission is finalized and the applicant remains in the program with no disruption.
This form can be completed by the applicant and/or family member and includes personal, social, health and treatment information.
In addition, we request a narrative from a family member about the applicant’s strengths and previous struggles, as well as in the applicant’s own words, what they hope to gain by coming to Gould Farm.
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.
This form is a writable pdf file that can be downloaded and filled out electronically by the provider or you may print it out, bring to the provider and they can fill it out and send it back to Gould Farm.
Release of Information Form
We would like to have any past records from hospitals, therapists, psychiatrists, or other information you think would be helpful.
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 Assitance 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.