Client Referral Form

What service is needed?
What grade is the child in?

Thank you for your referral!

Clinical Process: Once referral is received a case coordinator will contact you within 48 hours. The case coordinator will obtain a release of information (ROI), child's IEP or any other pertinent documentation and schedule an intake with youth's family, county worker and anyone else that needs to be involved. Intakes will be conducted by case coordinators who will create a Fundamental (treatment) plan to meet the youth's needs. Monthly follow-ups will be scheduled to track progress towards the Fundamental Plan goals.