Referrals

Possible Reasons for Referral
  • Academics
  • Divorce/Separation
  • Peer/Social Skills
  • School Discipline
  • Depression
  • Family Communication
  • Self-Esteem
  • Suicidal
  • Family Death
  • Abuse/Neglect
  • Substance Abuse
  • Parent-Initiated
  • ADHD
  • Physical Health
  • Developmental Delays
  • Self-Injurious Behavior
  • Physical Aggression
  • Verbal Aggression
  • Bullying
  • Anxiety
  • Resistance to authority figures
  • Adoption issues
  • Racial Issues
  • Family Trauma
  • Sibling conflict
  • Emotional expression
  • Family Blending
  • Life Transition
  • Incarceration
  • Chronic/Terminal Illness
  • Concerns around single parenting
  • Identity formation and exploration

To Submit a Referral

  • Have the student’s parent complete their portion of the form, consenting for this information to be exchanged between the school and our staff.

  • Mail referral form to:
    Jennifer Haislip 
    520 Butler Farm Road
    Hampton, VA 23666

  • Fax referral form to New Horizons at 757.221.1983. The family will then either be assigned to a counselor or placed on our wait list. You and the family will be contacted to notify you of that action.