COMPLETE REFERRAL PACKET INCLUDES THE FOLLOWING:

• Juvenile History: arrest history (open and closed cases) • Social Inquiry • Delinquent Acts and Charges • Delinquency Dispositions • All recent and previous Behavioral Health Evaluations (BHE’s) • Achievement Scores: IQ and Reading levels • DelStar Referral: Psycho-Sexual Evaluation • If client is 16-18 years old at time of referral a cross-search for any and all adult criminal court matters (open or closed) • Search Court of Common Please Criminal Docket through http://ujsportal.pacourts.us • School records including credits acquired • Individual Educational Plans (IEPs), if applicable • Recent drug screen results, if applicable • Discharge summary(ies) from all previous placements (delinquent and dependent) – placement history • Listing of any current services provided to the client • Next court date • Referring party’s Contact Information NOTE: For all residential referrals a face-to-face interview will be conducted in order to determine acceptability. For all day treatment referrals, where an IQ and/or Reading levels are not available, a face-to-face interview will be required. A reading assessment will be conducted in order to determine acceptability.

Submit referral information to:

SGS Court Staff Family Court 1801 Vine Street, 126M (Mezzanine Level) Philadelphia, PA 19103 Fax