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Referral to Whaley Children’s Center
 
 

How do I refer a child?

Children can be referred to Whaley Children's Center's Residential program in several ways.

One way is to call the agency at (810) 234-3603 indicating you are interested in referring a child for admission. Another way is to complete the Referral Form and submit it to us for review.

Once the referral information is received and reviewed, the screening committee reviews the information. The referring person will be contacted to schedule an intake interview if appropriate.

If a child has been accepted into Whaley's Program but an opening is not available, the child will be placed on the waiting list until there is an opening.

 

REFERRAL INFORMATION FORM

Child's Name

Birth Date
(MM/DD/YEAR)
County

Worker

Phone

Email
*

Male Female

Reason for entering care:

Current Placement

Presenting Behaviors

School Information

IQ Scores

Diagnosis

Medications

Family Involvement

Referral Date


 

 

 

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