Refer a Youth or Young Adult for Violence Prevention Programs

Please use this secure, confidential form to request outreach services for a youth or young adult. We'll respond within 7-10 business days.

You and/or the young person can also call us at (206) 749-7550 during business hours.

Your Information


Young Person Information


What contact info do you have for the young person? (please include all you’re are aware of):