If you are a clinical professional seeking to refer a patient to HRI Hospital for mental health treatment, please complete the appropriate forms below. We provide inpatient treatment, partial hospitalization programs and outpatient services to adults suffering from a psychiatric disorder or dual diagnosis.

If you are seeking treatment for yourself, please see the schedule an appointment.

Partial Hospitalization (PHP) Form Download

Release of Information Form

Completed forms should be faxed to 617-232-4914.

Call HRI Hospital at 833-468-2531 (833-INTAKE1) with any questions or concerns. We are available 24 hours a day, 7 days a week.