Consumer Driven Services Directory

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The Directory of Consumer-Driven Services (CDS), a project of the National Mental Health Consumers’ Self-Help Clearinghouse, offers essential information on consumer-run programs across the country, and provides links to education, training and technical assistance resources for these throughout the nation.

To apply for inclusion in the directory please fill out the program survey below, or download the application and return it to The Clearinghouse.

For questions regarding the CDS Directory and to obtain application/information materials please contact us by e-mail at info@mhselfhelp.org.

To download the word version of the application form please click here.

To download the .pdf version of the application form please click here.

1211 Chestnut Street, Suite 1100
Philadelphia, PA 19107
Phone: (800) 553-4539 or (215) 751-1810
Fax: (215) 636-6312
E-mail: info@mhselfhelp.org

Directory of Consumer Driven Services: Program Survey

Please fill in every field except those marked with * which are optional.

Contact Information (Information for The Clearinghouse only, will not be public)

Contact Person:

First Name:
Last Name:

Title:

Street Address:

City:

State

ZIP Code:

Telephone #:

*Fax #:

E-mail Address:

Program Information (Information to be printed in the CDS Directory)

Program Name:

Is this part of a larger Agency or Organization?

Yes | No

If Yes, Agency Name:

Year the Program was Started:

*Public Contact Person (if any):

First Name:
Last Name:

Street Address:

City:

State

ZIP Code:

Telephone #:

*Fax #:

E-mail Address:

or None

*Website URL:

Program Category:
(Choose a maximum of three that best describes your program)

*Target Participants:
(Many programs serve diverse groups. Please check ONLY if your program targets these groups as a specific part of its mission)

Program Setting:
(where the program is housed)

Annual Program Budget:

Number of staff:

Paid Full-Time

Paid Part-Time

Volunteers

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