Refer a Client - Compeer Chautauqa

Begin a Friendship Journey

Interested in referring the youth or adult you are working with to the Compeer Program for a volunteer friend or mentor? Click on the appropriate link below and fill out the referral form for a Compeer friend.

The referral is required to be completed by a mental health specialist.

Youth Referral Form (PDF)

Adult Referral Form (PDF)

Compeer Youth Referral

Please note the following eligibility criteria for the Compeer Youth Program:

Client is:

Ages 6-17 years old
Has a primary diagnosis of a identified mental health disorder
Lives in Chautauqua County
Wants a friend (Compeer Volunteer)
Not a current risk of harm to self or others
Willing to attend an orientation
Willing to complete Compeer questionnaire (provided after referral is received)

The Parent/Guardian:

Supports the referral
Commits to working in partnership with Compeer
Commits to completing annual survey
Willing to attend an orientation
Parent/guardian is willing to complete the client characteristic form

Referral Source: (professional completing this application)

Agrees to maintaining support/contact/updates with Compeer for duration of Compeer service or until counseling ends
Agrees to complete the Compeer annual survey.

Youth Referral Form (PDF)

Compeer Adult Referral

Please note the following eligibility criteria for the Compeer Adult Program:

Primary diagnosis is an identified mental health disorder
Client lives in Chautauqua County
Client is active in counseling/mental health services
Client wants a friend (Compeer Volunteer)
Client is between the ages of 18 and 59
Please note, all fields in the application are mandatory.

Adult Referral Form (PDF)