Montgomery Perinatal Program

How to Apply

Fax or email this form to:

Silver Spring Fax: 240-777-3054  SSHCReferrals@montgomerycountymd.gov
Germantown Fax: 240-777-4648  GCHReferrals@montgomerycountymd.gov

Eligibility Requirements

Program targets pregnant and families with newborns.  
Targeted Risk factors include:
• Pregnant Adolescents
• Late entry into Prenatal Care
• Pregnant person with Chronic Health Conditions
• First Pregnancies
• Prior Pregnancy Loss
• Pregnant person experiencing depression or other behavorial health concerns
• Pregnant person at risk for violence, emotions, sexual or physical abuse
• Pregnant person with health related social or financial needs (lacks housing, food, transportation, utilities)

Documents to Bring

Proof of Maryland Medicaid or lack of insurance.  Must live in Montgomery County and be pregnant or postpartum.

Fees and Payments

None

Frequently Asked Questions

1. When will I hear back?
Once a referral is received a public health nurse will contact you to set up home visits.  

Additional Information

There is no Additional Information at this time.




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