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Referral to Treatment or Support Services Application for S2S

Thank you for your interest in working with Mental Health America on our S2S platform. We are excited to list treatment resources for individuals using S2S. Please fill out the questions about your service or services below as accurately as possible using the content you want the end user to see. If you have any questions, please contact America Paredes at aparedes@mentalhealthamerica.net

If your image does not meet these specifications, we will have to contact you.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

Would you recommend your service to people who match the following characteristics described below? If so, check all that apply. Please note: it is important to be honest here. If a service isn't appropriate for someone with an eating disorder, don't suggest it! MHA reserves the right to finalize this list.

Please indicate the areas where your services are available below. If you are national, select national. For State, County, & Local, please include an excel document listing the states and zip codes where your services are available. 

Files must be less than 2 MB.
Allowed file types: xls xlsx.

Pricing Information

We want to make sure that any pricing information is clear and easy to understand for the consumer. Please provide a plain language description of your pricing as well as a link to full details. If there is no cost, please state that here.

Privacy Information

We want to make sure that any of our visitors fully understand how you will collect their data and what you might plan to do with it. If you are required to comply with HIPAA, please state here. You should include a brief, plain language summary of your privacy policy, letting people know how their data may be stored and/or shared. You must also provide a link to your full privacy policy. If this doesn't apply to you (books and videos), please enter N/A.

Disclaimers and Liability Information

Please include any other information that is relevant for your service in terms of disclaimers and liability. For example, if you work with individuals under the age or 18 or with legal guardians, include a statement on how you gain permission to work with them, referencing applicable law or regulation.  MHA may contact you for further information in this area.

MHA requires that each person who lists a treatment service has a direct phone or email contact for its users. Please provide either a phone number or an email--a link to a "contact us" form or a ticket system is not enough. If you have questions, please contact America Paredes at aparedes@mentalhealthamerica.net.

500 Montgomery Street, Suite 820
 Alexandria, VA 22314

Phone (703) 684.7722

Toll Free (800) 969.6642

Fax (703) 684.5968


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