All DJJS, DCFS/SOC and Juvenile Court referrals please use the following forms

Professional Referral

You have chosen professional referral indicating that you are a therapist, pediatrician or some other professional working with a child/family.

Please include the email that you would like all correspondence sent to you once the intervention begins. This includes a treatment plan, weekly notes, and a discharge plan.

It is helpful if you let the family you are referring know that our service is an intensive in-home intervention provided by behavioral specialist’s. We are in the home with a family approximately 8-10 hours a week during the intensive phases of the intervention and this time decreases as problems/concerns stabilize. Typical intervention last approximately 8-10 weeks totaling around 48 hours of face-to-face in-home visit time.

Our wait time is longer for scholarship families. If you feel you would like to discuss this family being moved up the list, please have the family contact Cameron Vankomen at 801-272-9980 to discuss payment options, or for any questions.

Please enter your email address

Select the type of referral