• Agency Referral Form

    Agency Referral Form

    Upon Completion of this form, HopeSparks will be able to refer you to the program that will best serve your needs or we will provide you with information to hopefully connect you with services elsewhere.
  • If you are experiencing a mental health emergency, please call 988.

    If you are in need of additional resources, please call 211.  

  • Personal Information

  • Programs

    HopeSparks Family Services available programs please check ALL that apply to you or the child you are calling for.
  • Behavioral Health Services

  • Children's Developmental Services

    Please select all that apply below.
  • Children’s Developmental Services provides early intervention for children from birth to three years old. A developmental assessment is used to evaluate each child’s individual strengths and needs to determine eligibility for services. If your child is found eligible, our Early Intervention Team will provide comprehensive services.

  • Family Support Services

    Please select all that apply below. Hover over an option to learn more about their respective program.
  • Your referral will be sent to all programs you qualify for.

    In addition, once you become an active HopeSparks client you will receive access to HopesCloset for basic needs including clothing, some household items and diapers.

    If you did not  qualify for any HopeSparks programs, please contact 211 for more information on resources that you may qualify for.

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