Online DJJ Referral Form

Welcome to the DJJ Referral form. Case Managers, Probation Officers, Directors, & Managers can use this form to refer youth for NPS services. This form is secure, for more information on NPS' Privacy Policies click here. Please complete the fields below and select Submit. The information is submitted to a secure location and you will be contacted if additional information is necessary. Most referrals require signed consent forms that can be submitted via fax or email. In order to download the consent forms, please click this button.

Click here to download consent form.

Baje aqui si usted consiente.

Please fax the consent forms to: 770-575-5608, Attn: RCC TEAM. However, faxing the consent forms is not required to complete and submit this online referral. Once you have submitted the online referral, you will be contacted to schedule your appointment. If you have any questions, you may contact the Referrals and Clients Communication (RCC) Team directly at 770-485-1675, or by email to NPS Care Coordinators:

Please choose to refer your youth for a Psychological Evaluation, or CORE Services, or both.

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