About Us
Counseling
- Youth Counseling Program
Family
Support
- Healthy Families
Early
Learning
- ReadySteps
- Growing Minds
Community
Engagement
Join Us
Donate

About Us
Counseling
- Youth Counseling Program
Family
Support
- Healthy Families
Early
Learning
- ReadySteps
- Growing Minds
Community
Engagement
Join Us
Donate

Youth Counseling Professional Referral

Contact

Counseling Referrals:
434.906.0763
counselingreferrals@readykidscville.org

Ashley Wood
434.296.4118 ext 273
awood@readykidscville.org

Mission and Vision
Make a Referral (Caregiver or Self)
Make a Professional Referral
Request a Training
Trauma-Informed Resources
Resources for Teens in Crisis

Youth Counseling Make a Professional Referral

"*" indicates required fields

Name of Person Referring*

Referring Agency*

DSS

FCAC

School

Police

Mental Health Professional

Other

If "other" please specify below.

Phone Number of Person Making Referral*

Email of Person Making Referral*

Youth's Name*

Youth's Pronouns*

Youth's Date of Birth*

Youth's Preferred Language*

Caregiver's Name(s)*

Caregiver's Phone Number

Caregiver's E-mail

Caregiver's Preferred Language

Youth lives in one of the following counties:*

Albemarle

Charlottesville

Louisa

Fluvanna

Greene

Nelson

Other

Youth must live in one of the above counties to participate. Please visit our Resources Page for other local healing opportunities. If you would like referral options, please call 434.906.0763 or email counselingreferrals@readykidscville.org.

Reason for making a referral for counseling services with Youth Counseling at ReadyKids:*

Has the youth experienced any of the following events? Check all that apply.:*

Victim of a crime

Witness to domestic violence

Witness to community violence

Experienced traumatic discrimination

Experienced trauma related to immigration

Experienced concerns related to gender identity and/or sexual identity

Other

Please provide a brief desscription of traumatic event*

Please describe any current concerns or symptoms the youth may be experiencing:*

Are there any ongoing or upcoming court or custody issues? Please describe: (if not applicable, please enter N/A)*

What services are already in place for the youth?*

DSS

DCJS

School-Based Supports

Mentor

Mental Health Counseling

Family Counseling

Other

None

Please describe other supports in place:

Youth would benefit from (referral coordinator will discuss options/eligibility):*

Trauma Counseling

Short-Term Teen Counseling

Unsure

Is the youth aware that this counseling referral is being submitted?*

Youth must be aware of counseling referral and willing to engage in the process in order to participate.

Is the youth's caregiver aware that this referral is being submitted?*

Yes

No

If needed, please provide any additional information:

Someone will follow up with you within three days to discuss the referral and gather any necessary additional information. After this communication, we will connect with the appropriate person to discuss the referral, gather any additional information, and screen for counseling program eligibility. Please call 434.906.0763 if you need additional information.

2021 Platinum Transparency Award from Guidestar

A Welcoming Safe Space for Everyone

Contact Us

info@readykidscville.org

Phone: (434) 296-4118
Fax: (434) 295-2638

1000 East High Street
Charlottesville, VA 22902

Parking on 11th Street

EIN #54-0546000

All of our programs have privacy policies in place to protect client information.

© 2023 Ready Kids | Website by Albano Design

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Thank you to the City of Charlottesville for celebrating the life and legacy of our dear friend, Eddie. ❤️

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Join us in our work today with the link in our bio, and give some digital flowers by tagging another nonprofit that deserves a shoutout below! 🌼💖

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