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Psychiatric Diagnosis Attestation for NYC Clubhouse Membership The following must be completed by a licensed clinical mental health provider: LCSW, NPP, PSD, PhD, MD, PA, HMC, MSW (if cosigned by
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Start by visiting the Clubhouse Services Mental Health website or office to access the necessary forms.
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Fill in personal information such as name, contact information, and any relevant medical history.
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Specify the type of mental health services needed and any preferences for treatment.
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Provide insurance information if applicable.
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Sign and date the form to attest to the accuracy of the information provided.

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Individuals struggling with mental health issues such as anxiety, depression, PTSD, bipolar disorder, etc.
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Anyone in need of professional mental health support and therapy.
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Those seeking a supportive community and resources to improve their mental well-being.
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Clubhouse Services Mental Health for All is a program aimed at providing mental health services to individuals in need.
Qualified mental health professionals are required to file Clubhouse Services Mental Health for All.
Clubhouse Services Mental Health for All can be filled out online through the designated platform.
The purpose of Clubhouse Services Mental Health for All is to ensure that individuals have access to quality mental health services.
Information such as patient demographics, services provided, and outcomes must be reported on Clubhouse Services Mental Health for All.
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