Self or Family Referral

The ReadyKids Teen Counseling program is short-term crisis counseling for teens and families.  Please fill out this form or call the 24/7 Teen Crisis Hotline to begin.  A counselor will reach out within 3 days to discuss  whether our program is a good fit for you/your child and make recommendations.

  • Date Format: MM slash DD slash YYYY
  • Initial Contact Information
  • Note: A counselor will reach out within 3 days to discuss referral to determine whether our program is a good fit for you/your child and make recommendations.
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