Youth Referral Guide

The Youth Referral Guide was developed by the Community Youth Services (CYS) Youth Committee at Vienna High School. The Guide lists and describes agencies providing services in or near the Johnson County community and includes physical and mental health resources, probation and court resources, basic needs resources, faith and community based organizations, and volunteer and employment resources.

It is the intention of CYS for the Youth Referral Guide to be distributed to areas and locations frequented by youth ages 11-24 within the Johnson County community. It is further intended to familiarize the youth with information regarding referral sources and the corresponding referral process.

Download the 2022 Youth Referral Guide

Youth Referral Form

If you are in need of youth services, please complete and submit the form below and list any/all services you may be interested in receiving.

Once a referral submission has been received, you will receive a response within 48 business hours. If you feel that you are in need of immediate assistance, please contact Arrowleaf at its 24/7 Crisis Hotline at:

618-658-2611 or call 911

Date of Referral*
MM slash DD slash YYYY
Name*
First Last
Phone*
Email*
Enter Email Confirm Email
Parent or Guardian Name (Optional):
First Last
Parent or Guardian Phone (Optional)
PLEASE LIST SERVICE(S) REFERRED TO OR INTERESTED IN RECEIVING:
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