Elevated Minds Youth Program
Interest and Referral Form
Information contained in this referral is of a confidential nature, please ensure any required consents accompany referral.
Thank you for your interest in the Elevated Minds Youth Program. We provide case management, counseling, mental health, and substance use education, resources, and referrals youth in grades 6-12.
To direct your referral to the correct staff member, please answer as many questions as possible on the following form. All information submitted by this form is confidential and only used to evaluate eligibility for our programs. Entry requirements vary by program, completing an interest form does not guarantee program entry.
