Referral Forms

All referral forms can be downloaded and faxed to us @ 814-201-2758. Please fill out all required fields so our staff can properly review your submission.


  •   Attendance Counseling Team 360⁰
  •   Delinquency Prevention
  •   Evolution Expressions Group Referral
  •   Family Adolescent Crisis Emergency Intervention Team (FACE IT) Referral
  •   CBT JPO Group
  •   JR. CEO
  •   Multidimensional Family Therapy Referral
  •   Outpatient Therapy Screening Form (Accepting Youth with Medical Assistance Community Care or UPMC)
  •   Substance Outpatient Services (SOS) Referral Form
  •   Triple P (Positive Parenting Program)
  •   Trauma-Focused Cognitive Behavioral Therapy
    (Referral Criteria)
  •   Victim Awareness Group