Refer a Child

The Admissions staff is available to answer your questions, assist with referrals, and provide specific information on The Barry Robinson Center’s programs and services.

Referral sources include:

Parents
Legal Guardians
Probation Officers/ Court Service Units
Social Workers/ Departments of Social Services
School Counselors/ Teachers
CSA/ Family Assessment and Planning Teams
Other Treatment Facilities/ Providers

The Center is a Medicaid provider for Virginia, West Virginia, North Carolina, and Washington, DC.

Referral information is received and reviewed by the Admissions office. A pre-placement interview may be conducted either telephonically or in person to obtain additional information regarding the client’s needs and to provide the client and family with information about The Barry Robinson Center programs. Consideration for Residential Treatment Services is aided by the following documents:

Psychological evaluation/ testing
Social history
IEP/ Educational reports
Most recent physical exam
Other relevant clinical reports from past providers or treatment facilities

Child's Information
Child's Name*
First Last
Date of Birth*
Gender*
Is the Child Currently in Treatment?*
- Yes
- No
If yes, Name of Provider*
Current Placement*
Name of Facility*
Current Medications, if any
What type of care are you seeking? (Select all that apply.)*
- Intensive Outpatient (IOP)
- Residential Treatment
- Substance Abuse
- Other
Referent’s Information
Referent Relationship*
Referent’s Name*
First Last
Address*
Street Address City State ZIP Code
Referent’s Email*
Referent’s Phone*
Type of Insurance*
Please provide a detailed message.*
How did you hear about The Barry Robinson Center?*
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Comments
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Refer a Child

Child's Information

Referent’s Information

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