For Crisis 24/7/365 • Call 855-581-8111 • Text 855-895-8398 Visit
Cass • Fremont • Harrison • Mills • Monona • Montgomery • Page • Pottawattamie • Shelby
Learn how to apply for our services and fill out our form for more information.

Please find below our Region Application along with our Notice of Privacy Practices. All residents of counties in the SWIA MHDS Region are eligible for Information & Referral and Crisis Services regardless of eligibility criteria.

Please see below for a brief summary of our criteria:

General Eligibility:

Diagnostic Eligibility:

Financial Eligibility:

You may fax application materials to our central office at 712-328-5668

You may mail application materials to our central office at

227 S 6th St, Ste 128
Council Bluffs, Iowa 51501

If you have questions about Region services or funding, please contact our central office at 712-328-5645.

Application Materials

This page was printed from the Southwest Iowa Mental Health & Disability Services Region on August 10, 2022. For the latest information, visit

The Your Life Iowa Crisis Line is available 24/7.

Your Life Iowa provides free, confidential support and connects you to resources meant to help you get your life back on track when derailed by alcohol, drugs, gambling, suicidal thoughts or mental health. Available 24/7 at (855) 581-8111 or text (855) 895-8398.

Have a question? You can also live chat with a representative on

If you or someone you know is in immediate danger, please dial 911.