S.O.R.T. REFERRAL

VOLUNTARY PARTICIPATION

Today, you have been identified as a youth that may benefit from services to prevent future contact with the Juvenile Justice system. As a result, you have been referred to SORT Resource Center for an assessment and possible implementation of services. SORT works to connect youth and families with services to support a safe and strong family environment.

For The Child:
By signing below, I agree to the following terms and conditions:

  1. I WILL make contact with SORT within 24 hours or the next business day.
  2. I WILL work with any recommended counseling service as directed by SORT staff.
  3. I WILL attend all suggested activities as requested by SORT staff.
  4. I agree that failing to follow rules may result in my termination from SORT.
  5. I understand if I fail to report to SORT as directed that I may not be provided a future opportunity to participate in a diversionary program.

    For The Parent/Custodian:
    By signing below, I agree to the following terms and conditions:

    1. I WILL make contact with SORT within 24 hours or the next business day.
    2. I WILL cooperate with SORT staff at all stages of the Diversionary Program.
    3. I WILL ensure the child attends counseling sessions as directed by SORT.
    4. I WILL make all efforts to ensure my child’s attendance at all SORT activities.
    Child Name
    Guardian Name
    Guardian Address
    School (pick one)
    School Representative