How to Apply
By establishing this website, “Teejuh’s” goal is to display to the caller a safe, and confidential way to request help.
If the caller would like to request “Counseling Services,” Teejuh has eligibility requirements to meet, through a “Grant,” aligned to 40002(b)(2) of the Violence Against Women’s Act, as amended (42 U.S.C. 1395(b)(2)).
To help guide the caller, he/she can read the following documents Patient Admission & Eligibility and the Policy & Procedure: Program Eligibility, which will detail to them, our eligibility protocols for services.
In addition to eligibility requirements, the caller will need to complete the Registration Application which will be needed for our medical provider of record.
Once the form is completed, it will automatically be submitted to “Teejuh’s” program director for processing and/or following-up.
If you choose to print the form, please print, complete and bring it with you to your appointment.