Take Control - Belknap County 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Referral Date' and 'Intake Date' at the top of the form. These dates are crucial for tracking the referral process.
3. Fill in the 'Referral Source' field to indicate where the referral originated from, ensuring accurate record-keeping.
4. Provide the child's name, age, and date of birth in the designated fields. This information is essential for identifying the child involved.
5. Complete the address section with accurate details to facilitate communication and follow-up.
6. Input contact information for both parents or guardians, including home, cell, and work numbers as applicable.
7. Indicate whether the family has been notified of this referral by selecting 'Yes' or 'No'.
8. Answer if the family is open to intervention by selecting 'Yes' or 'No'.
9. If there is a history of violence or threatening behavior, provide detailed explanations in the space provided.
10. Finally, articulate the reason for referral in detail to ensure clarity on why this intervention is necessary.

Start filling out your Take Control - Belknap County form online for free today!