Residential Referral Process

Third Way Center’s referral process begins with completing the below referral form. Please complete the form and email it along with the following supporting documents. For our community based programs (York, Pontiac, Bannock, and Lincoln), please send the completed referral forms to Dave Eisner at For staff secure referrals, or if you are unsure which program to refer to, please email Amber Lacy at

EFFECTIVE AUGUST 28, REFERRALS SHOULD BE SUBMITTED TO    (DYS referrals can continue to be sent to

Additional Documentation

In addition to the above Referral Form, please also include as much information as possible from the bullet points below.  This will greatly help to assess the client and expedite the process.  

    • Psychological/Neuropsychological Evaluations and all testing, including IQ/IEPs
    • If youth is offense specific; History and Maintenance Polygraphs, Monthly Treatment Reviews/updates of previous treatment
    • Placement history and discharge summaries from previous placements
    • Family Treatment/ Service Plan
    • Any medical information that may pertain to their mental health
    • Health Passport (date of last physical, dental, vision and immunization records)
    • Legal History
    • Trails ID, copy of Birth Certificate, Social Security Card or number and Medicaid numbers (MUST HAVE PRIOR TO PLACING YOUTH)

Admission Packet

Once your youth has been accepted to the program and moves in, staff can send you documents from the intake packet for electronic signatures. Keep an eye out for those emails to sign at your convenience from any device.