Foundry Comox Valley Referral Forms
Use one of the forms below to refer a youth to Foundry services.
Youth are also welcome to come in during our drop-in hours to request any services they require, with or without a referral.
Who fills this out? Professionals, community members, or family members on behalf of a youth age 12-24 who may benefit from services, programs, and/or groups offered at Foundry.
CREATING YOUR CIRCLE OF CARE: Consent to collect/use/disclose information
Who fills out? The youth requesting services. Who signs? The youth and a witness, and a parent/guardian if youth is under 12. Why? It allows information needed for the youth to participate in requested services to be shared between people they select.
CLIENT RIGHTS AND RESPONSIBILITIES
Why? This brochure explains what clients can expect from our services.
PARENT/GUARDIAN CONSENT FOR YOUTH UNDER 12
Who fills out? A parent/guardian of a youth who wants to participate in a group that is hosted by Foundry Campbell River, but is under 12 years of age.