Primary Care Behavioral Health

Application Requirements

             I want to take the program Individually using my own PC (1 step):

                                        Step 1:    Individual PC user Application Form

            I want to Host a group of participants at my site (2 steps):

                                        Step 1:    Site Registration Form

                                        Step 2:    Application Form for Participants who are part of a Group

Please submit completed applications to: UMass Medical School, FMCH, 55 Lake Ave North, Benedict Bldg, A3-234, Worcester, MA 01655 or fax to, 774-441-7799, Attn: Amy Green.