Grow Academy Referral Information & Forms

The Grow Academy Referral Requirements

All referral paperwork listed below should be sent to: GrowAcademy@wisconsin.gov

All new referrals will need the following paperwork, prior to the youth and guardian(s) being interviewed:

 

1.       Referral and Face Sheet (DOC-1615)

2.       Copy of Court Dispositional Order; please note any No Contact orders

3.       Current risk assessment

4.       Prior psychiatric assessments (if applicable)

5.       Additional information (prior history, prior placements, progress summaries, etc.)


The Grow Academy Social Worker/designee will arrange for an initial interview with the youth and guardian(s) after receiving the above information.  When the interviews are complete, the Grow Academy Social Worker/designee will inform you of an acceptance or denial of the referral.


Once an acceptance to the referral is communicated, the following paperwork MUST be completed and sent to the above email, or handed directly to the Grow Academy Social Worker/designee, before the youth will be admitted on grounds at The Grow Academy:
 

6.       Authorization for Disclosure of Non-Health Confidential Information (DOC-1163) – complete items   1-7, sign & date

7.       Medical Services Consent (DOC-3749​) – include proof of insurance

8.       Physician Recommendation (DOC​-3748)

9.       Psychiatrist Recommendation (DOC-3748A) (if applicable)

10.     Telepsychiatry Informed Consent (DOC-3754​)