Please complete this entire form for access to the NYC SMH Digital Resource Center website. Make sure you provide your correct organization (work) email. Personal email addresses are not accepted. Thank you!

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Agency Name:	Please select from list. Abbott House Association to Benefit Children Astor Services Bent on Learning Brain Power Wellness Bring Change to Mind Bronx Works Brooklyn Center for Psychother Bedford-Stuyvesant Family Health Center Brownsville Multi-Service Family Health Camba Center for Supportive Schools Central Queens Y Cypress Hills Local Development Child Center of NY Childrens Aid Childrens Aid Society Community Association for Prog Community Counseling and Media Community Health Care Network Counseling in Schools Dominican Womens Development Center Eastside House East Harlem Council For Human Services Educational Alliance Elevate Enact Inc Engaging Schools Fordham University FranklinCovey Global Kids Good Shepherd Services Gotham Health - Bellevue Gotham Health - East NY Diagnostic & Treatment Center Gotham Health - Elmhurst Gotham Health - Morrisania Gotham Health - Queens Gotham Health - Renaissance Gotham Health - Woodhull Graham Windham Grand Street Settlement Inc Harlem Family Institute Health and Hospitals Heritage Health Care Center Henry Street Settlement Hey There Beautiful Interborough Development & Consultation Center Institute for Family Health Jamaica Hospital Medical Center Little Flower Yoga Maimonides Medical Center Make the Road New York Mental Health Providers of Western Queens Montefiore Morningside Center for Teaching Morris Heights Health Center New York Center for Interpersonal Development Northwell Health The NYC Department of Health and Mental Hygiene NYU Lutheran The New York Foundling NY Presbyterian NYC Community Learning Schools Office of School Mental Health Partnership With Children Pathways to Leadership Powertools Ramapo for Children Replications Inc Rising Ground Ryan Health Research Foundation of SUNY Research Foundation of SUNY at LICH Staten Island University Hospital Sheltering Arms or Safe Space Southern Queens Parks Association Sports and Arts in Schools Foundation/NY Edge St. Nicks Alliance START Treatment and Recovery Centers The Door The Guidance Center of Brooklyn Heights The Jewish Board or JBCFS Union Settlement University Settlement Urban Health Visiting Nurse Services Wediko Childrens Services William F Ryan William F Ryan - Chelsea Clinton William F Ryan - Nena Woodhull Hospital
School District Number:	Please select from list all that apply. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Grades:	Elementary Middle High School K-8 K-12 6-12

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