We accept referrals from human services agencies, mental health centers, providers, probation officers, and schools.

Referrals may be made via fax, phone, e-mail, or the form below. Referrals will be reviewed by the admissions team in consultation with medical, educational, and clinical staff to determine whether a child is appropriate for services. Admissions staff will notify the referral source of the availability or a tentative admissions date if there is a waiting list.

Referrals should include documentation which describes the child’s behavioral health history, school functioning, and presenting problems. These documents may include service plans, psychiatric assessments, Individual Education Plan (IEP), and any other diagnostic information that is applicable.

Once paperwork is received, we will conduct a brief screening by phone to determine your needs and discuss programming options. Next, if appropriate, we will schedule a face-to-face interview and make a plan for admission. If we are unable to provide services, we will do our best to refer to an agency better suited to meet the needs of the clients. 

Referral Source Name *
Referral Source Name
Referral Source Phone Number *
Referral Source Phone Number
Referral Source Fax Number
Referral Source Fax Number
Programs *
Please select at least one referral program.
Date Placement Needed
Date Placement Needed
Open DHS Case
Does client/family have an open case with Department of Human Services, including D&N?
Client's Name *
Client's Name
Date of Birth *
Date of Birth
IEP
Individualized Education Plan
GED
Race
Viable Family *
Primary Caregiver Name *
Primary Caregiver Name
Is Primary Caregiver Legal Guardian?
Caregiver Phone Number *
Caregiver Phone Number
Address *
Address
List names and roles of others living in the home.
Socioeconomic Status
Please provide names, phone numbers and e-mail addresses for other stakeholders, including caseworker, probation, GAL, and other professionals.
Payment Information (must select one or more) *
Include medicaid/insurance number, name of payer agency, authorization number, dates of authorization, contact information for payer agency, and/or explanation if :other: selected above.
Trauma *
Check all that apply.
Current Behavioral Concerns *
Check all that apply.
Please provide provider information and/or verification of treatment.
Includes psychiatric, residential, sub-acute, in-patient, and ER mental health evaluations.
AWOL/Runaway Risk Level *
Aggression Risk Level *
Self-Harm Level *
Suicidality Risk Level *
If applicable.
Name and code
Prescribed By
Prescribed By
Intellectual Disabilties
About client or family engagement.

Denver Children's Home will respond to referral requests in a timely manner as noted above. Any additional required documentation should be sent to admissions via e-mail at admissions@denverchildrenshome.org or fax at 303.399.9846.