Self Referral Form

Our staff is here to help you deal with non-urgent issues! We can personally connect you to services in New York City that can make your life a little easier. Please fill out the form below and someone will be in touch within two (2) business days.

Please note that we only provide assistance for scholars and families who are enrolled in the BridgeUP program. If you are NOT in the BridgeUP program, click here for the link to our NYC Community Resource Guide for services.

If you are in crisis and need to talk to someone about a mental health or substance abuse issue, call 1-888-NYC-WELL or you can text WELL to 65173.

If you are having an emergency, a situation that threatens your health, or the health of someone in your family, call 911.