Erie county 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the referral date at the top of the form. Ensure all information is legible and complete.
3. Fill in the Referred Youth’s Information section, including first name, last name, date of birth, gender, race, and primary language. Be sure to include contact details such as address and phone numbers.
4. Complete the Parent or Guardian Information section with similar details for each guardian. Include their relationship to the youth and health home enrollment status.
5. In the Referral Source Information section, provide your agency's name, title, contact information, and any relevant supervisor details.
6. Select the appropriate Type of Referral and indicate if it relates to Child Welfare or Juvenile Justice.
7. Continue through sections regarding Youth Information, Household Composition, Past System Involvement, and Current System Involvement. Fill out all applicable checkboxes and provide explanations where necessary.
8. Finally, review all entries for accuracy before submitting your completed form through our platform.

Start filling out your Erie County Referral Process Form today for free using our editor!