Submit a Service Referral

Please ensure all text fields are completed to the best of your ability prior
to submitting the referral to prevent any delays in beginning services. 

With any questions, feel free to contact:

Is client placed in Foster Care or Relative placement?

If you would like to add any additional information (Affidavit, Service Plan, protective order, etc) feel free to do so here: 

Upload File
FAPT Approval for RFS services?