Juvenile Anger Management

Referral Instructions

Please complete the referral form below to enroll in the Juvenile Anger Management Program. This program is designed to help youth develop healthy ways to understand, express, and manage anger while building emotional awareness, self control, and positive decision making skills.

The program focuses on identifying triggers, understanding the anger cycle, improving emotional regulation, strengthening communication skills, and learning effective coping and conflict resolution strategies. Sessions are developmentally appropriate and use trauma informed, evidence based approaches to support growth and accountability.

Please include any court orders, probation requirements, school referrals, or completion deadlines in the additional notes section of the referral form. This information allows our team to ensure appropriate documentation and coordination.

Once the referral form is submitted, our team will review the information and contact the parent or legal guardian to discuss enrollment, scheduling, attendance expectations, and payment details unless otherwise noted. If you have questions or need assistance completing the referral form, please contact our office for support.

Juvenile Anger Management

This field is for validation purposes and should be left unchanged.

Student Information

Full Name(Required)
MM slash DD slash YYYY
Your Email Address(Required)
Address(Required)
When is the best time for us to reach you via telephone?

Parent/Guardian Information

Full Name(Required)
Your Email Address(Required)

Case Manager Information (If Applicable)

Full Name
Case Professional Email Address

Service Information

Services Needed(Required)
Transportation Needed?
How did you hear about us?(Required)

Consent + Agreement

I hereby confirm that the information provided above is true and accurate. By typing my name below, I acknowledge that it serves as my electronic signature.
Consent(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY