Program Referral for Lakeland Family Resource Center

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Lakeland Family Resource Center offers a number of support programs to all families and caregivers.

If you know of someone or yourself that could use the extra support, please let us know and we will connect with them.

We strive to offer a warm, welcoming, supportive environment. All referral information will be kept confidential to honor the privacy of the person referring.

Name of person making the referral(Optional)

Phone Number of person making the referral(Optional)

Name of person in need of support *

Phone number of person needing support *

This person is experiencing:

Divorce or Seperation

Child Custody/Placement

Illness or Death in the Family

Mental Health

Transportation Barries

Job Loss/Unemployment

Struggles with Child Behavior/Parenting

Living Arrangments

Incarceration/Probation/Parole

Substance Abuse

Domestic Abuse

Other(Please include in notes below)

Notes or other information that would be helpful to know about this individual or family

Thank you

Reaching out for help can be scary. Thank you for taking the steps in getting someone the help and support they may need.

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