Refer a youth

Submit a referral for Emergency Placement or Residential Level 3 care.

Fill out the form below and our admissions team will be in touch within two business days. Crisis placements: call 816-761-CARE directly.

Fields marked * are required.

Youth Information

First name *

Last name *

Date of birth (optional)

Gender identity (optional)

About You

Your name *

Title / Role (optional)

Organization / Agency (optional)

Phone number (optional)

Email address *

Placement Details

Type of placement needed *

Urgency *

Current living situation (optional)

Reason for referral *

CS9 Document (optional)

Attach the Missouri Children's Service Form 9 if you have it available. You can also email it to admissions after submitting. PDF, JPG, or PNG · max 10 MB.

Crisis placement? Call us directly at 816-761-CARE. We respond to all referrals within two business days.

What happens next

We receive your referral within minutes
Admissions reviews within two business days
We contact you with fit and availability
If accepted, you'll receive a secure intake link
Admit date set and care team introductions made

Direct line

For urgent or crisis placements, call us directly.

816-761-CARE