Referral Form Reason For Referral Date of Referral Georgia division of family & children services (DFCS) involvementYesNo Department of juvenile justice (DJJ) involvement YesNo Assessments-Please Select-Substance AbuseParental FitnessAnger ManagementDomestic ViolenceTrauma AssessmentBonding/AttachmentPsychologicalPsychiatric CLIENT DYNAMICS Date of Birth SexMF Address Service Authorization Number Referring County (For DFCS use only)
