Thank you for completing your request to stay with us. Before you submit your application, please carefully review the following requirements to ensure your request is not delayed:
Each family must submit an online request form for current and future stays.
Every request must be verified by a staff member from the treating medical facility. Our team will reach out directly to the treatment representative that you list and provide on this form. Submitting an application does not guarantee a room. Please allow 3-4 business days for us to review your application.
Please call Mollys House if your request is urgent- (772) 223-6659.
Submittal of request does not guarantee or hold a room. You must provide a photo ID, complete registration/orientation process, and agree to Conditions of Stay.
All demographic and household income questions help our organization improve our services and provide essential reporting data for securing funds that sustain our program. This data is never reported in ways that are personally indefinable, nor is it used to determine eligibility for our services.
Household is defined as all those who live in the same dwelling as the patient as their primary residence.
Molly's House is a charitable 501(c)(3) organization (EIN 65-0407242). Your contribution is completely tax-deductible to the fullest extent of the law.
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