THE ASSISTANCE REQUEST FORM


July 9, 2021 Update: 

We are currently pausing our financial assistance requests. We certainly can help you find a resource or refer you in the meantime! 

 

 

If you are in need of any assistance regarding mental health, please continue to fill out this form. Whether it's with finances for a mental health service you are receiving, a referral for a mental health service you are seeking, or if you are just in need of a resource, you name it.

Please note that all fields are required.

 







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Financial Assistance
Referrals
Resources


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No



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Call
Text
Email


The Butterfly Path Team will review your request and be in touch shortly. We want you to know that this will stay confidential.