School Admissions Inquiry

To learn more about Green Chimneys’ special education or residential treatment program for your child, student or patient, please complete the form below.

Thank you for your interest in Green Chimneys.

All information submitted within this form is confidential.

Please note that school district referral is required ahead of application to our program. Tours are offered following student referral, and upon determination of program appropriateness for the student’s individual needs.

Please review our Admissions Criteria before completing the form below.

  • Child's Birthdate
  • Child's State of Residence
  • Has your district already made a referral? (required for application)