Language
  • English (US)
  • Membership Eligibility

    This form must be filled out and signed by healthcare practitioner/doctor such as Psychiatrists, Mental Health Care Provider, Physician, VRS or DOR Counselor.
  • California Clubhouse is a membership based social/vocational community for individuals 18 years and older with a mental health diagnosis. We require an application, eligibility form and an orientation to participate.

    Eligibilty Form must be completed by Psychiatrists, Mental Health Care Provider, Physician, VRS or DOR Counselor.

    All participation is voluntary and at no cost to members. 

  • To be eligible for California Clubhouse programs, members need to live in San Mateo County*, be 18 years of age or older, and have a diagnosis of Schizophrenia Disorder, Schizoaffective Disorder, Bipolar Disorder, Major Depressive Disorder, Anxiety Disorder, PTSD or Depression.

    All information will be kept confidential.

    *If you do not reside in San Mateo County, connect with us via email or phone.

  •  - -
    Pick a Date
  • Referral Source

  • Mental Health Professional

  • Mental Health Diagnosis and Medications:

  • Clubhouse Community Safety:

    As part of our standards, we ask about recent history of violent behavior to ensure a safe environment for all members. Members with past accounts of violent behavior or criminal records may still be eligible for membership.
  • Psychiatric History:

  •  - -
    Pick a Date
  • Clear
  •  - -
    Pick a Date
  • Should be Empty: