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On-line application
In a crisis? Call 301-925-9120
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Who is Eligible?
  Any Individual who:  
Is experiencing a psychiatric crisis.
Requires a temporary separation from his or her current living situation.  
Can care for her/his physical needs and basic personal hygiene, with staff support if necessary.  
Agrees to follow the rules and participate actively in his/her treatment.  
Is currently in an inpatient psychiatric unit.  
Is Medicaid eligibile, has Medicaid, Medicare or is uninsured.  
Has commericial insurance -- to be expanded  
 
 
   
   
   
   
  Hyattsville EMR Staff Login:  
  Gaithersburg EMR Staff Login:  
 

Waldorf EMR Staff Login:

 
 

Ellicott City EMR Staff Login:

 

 

 

 

 

 

 
Download Application Form:
Please click on the link above to download the eligibility application PDF. The application can be faxed to 301-925-4328.
   
 
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Apply on-line: (not available at this time)
You may fill out the eligibility application on-line by clicking on the link above. Please use the Account Name of "eligibility" and leave the password field blank.

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Location I Crisis Beds (SJH 1)
Location II Crisis Beds (SJH II)
6910 Annapolis Road
Hyattsville, MD 20784
Office: 301-925-9120
Fax: 301-925-4328
4607 69th Avenue
Hyattsville, MD 20784
Office: 301-386-0014
Fax: 301-386-0018
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Staff Login: