Make a Referral
If you are wanting to submit a referral for either Child-Focused Recruitment or Family Preservation Services, see below for the proper forms.
What Type Of Referral?
Child-Focused Recruitment
CHS in partnership with NCDHHS serves all 100 counties across North Carolina within the Child-Focused Recruitment Program. To refer a youth for Child-Focused Recruitment services, please download and complete the referral form below.
Child-Focused Recruitment Referral Form
Intensive Family Preservation Services
Please download and complete the referral form. Fax the completed form to the local region listed below:
Alexander, Alleghany, Ashe, Burke Caldwell, Catawba, Watauga, Wilkes
Fax: 336-690-5425
Cleveland, Lincoln, Mecklenburg, Stanly
Fax: 336-303-4168
Union, Cabarrus, Gaston
Fax: 336-790-4944
Durham, Edgecombe, Nash, Wilson, Wayne
Fax: 336-790-4248
Franklin, Granville, Johnston, Vance, Wake, and Warren
Fax: 336-303-4167
Department of Social Services Referral Form

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