How to Refer

Referrals for any of our services can be submitted by the parents or caregiver, DCFS social worker, and Foster Family Agency social workers.

Please download and complete the referral form by clicking the following link:

Counseling4Kids Referral Form

Once you have completed the referral form please submit via email or fax.  Submission details are on the top of the form.

Referrals submitted without supporting documentation will be returned.  For timely service it is important to provide all documentation with submission.

Referral contact –  Client Services Department 


Phone: (310) 817-2177

Fax: (310)817-2178