Referral Process

Upon receiving the referral, the youth and parents will be contacted to set up an intake appointment.  During the initial meeting the Outreach Program Coordinator will go over each of the program descriptions and recommend which programs would be most fitting to a youth’s needs based on the assessment and referral information.  This is a voluntary program and therefore, youth must be willing to participate in order to enroll.


You can refer a youth to Youth Diversion by:

  • Filling out the online form below
  • Completing and submitting the provided referral form Referral Form  (in Word). Referral forms can be faxed to 519-253-6476 or emailed to
  • Call the Youth Outreach Staff at (519) 253-3340 ext 222 and have a referral form completed over the phone.
  • Client Information

  • Date of Birth:
  • Please enter a number from 1 to 31.
  • Referral Source

  • Referral to Programs

  • Reason for Referral