Referals


The following forms are to be used for referrals by professionals only (CAS, clinicians/therapists, probation/diversion, psychologists/psychiatrists, etc.). Please choose the correct form when making a referral. For example, the referral form labeled ‘Prevention’ should be used for adolescents (12-18) who have sexually offended and children (under 12) who have engaged in problematic sexualized behaviour. Alternatively, the referral form labeled ‘Trauma’ should be used for children and adolescents (aged 3-18) who have experienced interpersonal violence (physical, sexual, emotional abuse, neglect, or witnessing domestic violence). Please note that a follow-up call must be made to our agency within 72 hours of sending the form in order for the referral to be considered. To securely send your completed referral form please email to Leasa Hennessy at leasa@haltontraumacentre.ca