Referring Teens & Families to Casa Youth Shelter

Whether you are a teacher, counselor, social worker, case manager, or first responder, the Casa Youth Shelter referral form is for all professionals who work with teens and families in crisis. When you fill out and submit the form below, a CYS staff member will reach out to discuss the crisis situation with the teen/family and to assess whether our services are appropriate.


Once a referral form is submitted, a CYS staff member will follow up with the teen/family within 4 hours. It is important to note that the teen/family must consent to the referral source sharing their contact information. If they do not consent, we will be unable to call. 


Our professional partners play a critical role in supporting youth and families in need. They are often on the front line offering guidance regarding resources in our community. The CYS referral form hopes to eliminate barriers for those in need. It is no longer up to them to initiate contact by calling us. A referral allows us to reach out to the family in need, extending our support during a difficult situation and hopefully making it easier for them to hear how we can help and request services.


To submit a referral, please complete and submit the form below.
Forms may also be downloaded here, completed, and emailed directly to

Casa Youth Shelter Referral Form