The following form will help you determine if MHYR is a suitable program for your troubled teens needs. The first set of checkboxes are conditions that we treat at MHYR. The second set of checkboxes with criteria marked in red are conditions that you will need to contact a MHYR admissions counselor to determine enrollment eligibility.
If any checkboxes below are marked please contact a MHYR admissions counselor to see if an exception can be made for your teen. The admissions number is: (866) 781-2450
First Name* Last Name* Address City Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbia (District of)FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Province Zip Country Phone Email* Please include comments about your child's struggles or questions for MHYR. Packet Delivery Options: Emailed Priority Mail Faxed Include MHYR DVD? To have an admissions counselor call with more information, please specify a number and time to call between 9am-5pm MST.
(Items with an "*" are required)