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Apply for Services

If you believe you qualify for Housing Stabilization Services and would like Bridgewater to support your housing journey, please complete the application form below. Our team will review your submission and contact you to discuss next steps. All information is confidential.

Note: This form is for initial inquiry only. A full eligibility determination requires verification of Medical Assistance coverage, disability documentation and a person‑centered plan.

Full Name *

Date of Birth *

Phone Number *

Email Address *

Current Address

Do you currently receive Medical Assistance (MA)? * --Please select-- Yes No I'm not sure

Do you have a disability or long‑term medical condition? * --Please select-- Yes No I'm not sure

Which situation best describes your housing status? * --Please select-- I am currently homeless I am at risk of homelessness I am moving out of an institution or licensed setting I am at risk of institutionalization Other/Unsure

Briefly describe the assistance you are seeking

Submit Application

If you prefer, you may also apply by phone at 763‑228‑4903 or email us at admin@bridgewservices.com.