Referral Forms

Referral Process:     Any youth interested in making a referral (or anyone interested in making a referral on behalf of youth), may contact HCI directly and speak to an Outreach Worker or may fill out the brief referral form attached and send to either:

Mail:         375 Main St., Rockland, ME  04841        

Fax:          207/596-0350

Email:       For Knox, Lincoln, Sagadahoc and Waldo Counties:
                  akoehling@homecounselorsinc.org

An Outreach Worker will be dispatched as soon as possible to meet with youth.

 
Basic Referral Form:     HYO referral form