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.

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.

Referral Form

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 professional.

Referral Form