Referral Forms

You First has made it simple to complete referral forms directly from our site. Depending on which service or services you are seeking, select and complete the referral forms required to begin service. Each service will have specialized requirements on who can complete a referral form.

Applied Behavioral Analysis (ABA)

The ABA referral form must be completed by one of the following: Clinical Psychologist, Nurse Practitioner, Neuropsychologist, Pediatrician or Developmental, Pediatrician, Pediatric Neurologist or Child Psychiatrist.

ABA Referral Form

Psychiatric Rehabilitation Program (PRP)

The PRP referral form must be completed by one of the following: Licensed Mental Health Professional, including Psychiatrists, CRNP-PMH, Licensed Psychologists, LCSW-C, LCPC, APRN-PMH, LCMFT, LCADC, LCPAT, LGMFT, LGADC, and LGPAT. LGPC, LGMFT, LGADC, LGPAT, or a LMSW. Referrals from non-mental health professionals are not permitted.

PRP Referral Form

Mental Health or SUD Therapy

A therapy referral form can be completed by: anyone who has a relationship with the client, you do not need to be a licensed mental health or SUD professional.

Therapy Referral Form

Care Coordination for Children and Youth

A care coordination referral form can be completed by: their parent/caregiver, through the public schools, therapist, social worker, case manager, or anyone. who has a relationship with the client.

Care Coordination Referral Form