Client Referral Form | The Village Family Service Center

The Village Family Service Center

Client Referral Form

Thank you for choosing The Village Family Service Center. We look forward to partnering with you in your patient’s care. For more information on our different programs and services, click the appropriate link below: 

Outpatient Counseling | Intensive Outpatient Program (Mental Health) | Chemical Dependency Treatment (First Step Recovery) | In-Home Family Therapy | Financial Counseling | Pregnancy Counseling | Adoption Services


To make a referral, simply fill out the form below. Once you've submitted this form, our Client Services Team will contact your patient to schedule an appointment with one of our Mental Health Professionals.