School of Education

New Horizons Family Counseling Center

Referrals

Reasons for referral to services at NHFCC


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

Complete the referral form below, including student and family information.
New Horizons Family Counseling Center Referral Form [doc]

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:
Attn: Ernestine Jones
520 Butler Farm Road
Hampton, VA 23666
You may also fax the form to: (757)221.1983

After mailing or faxing your referral to NHREC, please fax referral form to New Horizons at 757.221.1983. Upon receipt, the family will be contacted to complete an intake. This intake is needed before we are able to assign the family to a counselor. Once the intake has been completed, the family will either be assigned to a counselor or placed on our wait list. The referral and the family will be updated on any case action.