I am running a make-table query which needs to find a date that matches the input date or find the nearest within the last 180 days.

SELECT DISTINCTROW TPData.[Date Received], TPData.ID, TPData.[Specimen No], patient.forename, patient.surname, episode.admitdate, episode.dischdate, patientdod, episode.cc, episode.place, episode.wcode INTO Patient_July2004
FROM ((episode INNER JOIN numberlinks ON episode.link = numberlinks.link) INNER JOIN patient ON episode.link = patient.link) INNER JOIN TPData ON numberlinks.number = TPData.ID
WHERE (((TPData.[Date Received]) Between #6/1/2004# And #6/30/2004#) AND ((episode.admitdate)<=[Date Received] And (episode.admitdate)>([Date Received]-180)) AND ((episode.place)="Home1" Or (episode.place)="Home2") AND ((numberlinks.Homelink)=1))
ORDER BY TPData.[Specimen No], episode.admitdate DESC;

When I run this I get the dates that are 180 days old not the one that is nearest to the date received.

How can I run the query so I can get the date nearest to the date received? The date is always before the date received.

By nearest do you mean closest to or most recent before?

e.g., if the input date is 10 days ago, then 9 days ago is just as close as 11 days ago. (tomorrow = yesterday)

make a field that subtracts the date field from the input date, and use dmin with filter on neg/pos or dmin(abs()).

That's cool but what I am trying to do is find the first date prior to the date received within the last 180 days

Right.
Make your query1 find the difference in dates, filtered on <=180 days. Make a query2 based on query1 to find the minimum of that difference.