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.

Our Flyer

Our Brochure

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:

Region #1

Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain, Transylvania, Eastern Band Cherokee Indians:
Fax: 828-475-6846

Region #2

Avery, Buncombe, Henderson, Madison, McDowell, Mitchell, Polk, Rutherford, Yancey:
Fax: 828-475-6846

Region #3

Alexander, Alleghany, Ashe, Burke, Caldwell, Catawba, Watauga, Wilkes:
Fax: 336-690-5425

Region #4

Cleveland, Lincoln, Mecklenburg, Stanly:
Fax: 336-303-4168

Gaston, Cabarrus, Union:
Fax: 336-790-4944

Region #5

Davidson, Davie, Forsyth, Iredell, Rowan, Rockingham, Stokes, Surry, Yadkin:
Fax: 336-270-2005

Region #6

Alamance, Caswell, Chatham, Guilford, Orange, Person, Randolph:
Fax: 336-270-2006

Region #8

Durham, Edgecombe, Nash, Wilson, Wayne:
Fax: 336-790-4248

Franklin, Granville, Johnston, Vance, Wake, Warren:
Fax: 336-303-4167

Our Flyer

Our Brochure

Department of Social Services Referral Form

Department of Juvenile Justice Referral Form

Child Mental Health Referral Form

Get Involved

Our community is vital to our success. Find out how your time, talent and resources can help more children find and experience loving families.

Donate Now

It takes a village to raise a child. And it takes a community to affect lasting change. Invest in the lives of children and make a difference for families everywhere.