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YOUNG ADULT REFERRAL

Had worries that would not stop?
Thought you don't have anyone to be honest with about your thoughs and feelings?
Used drugs and or alcohol to deal with thoughts and feelings?
Had sadness that would not stop?
Engaged in risky behavior that concerns you?

Consent

By completing this form you are agreeing to submit the information to a mental health provider to get the process started for therapy services.