Make A Referral

POETIC is an in-community aftercare program for girls (12-24) who have experienced child maltreatment, commercial sexual exploitation (CSE) or domestic minor sex trafficking (DMST).

Please use this form when referring a girl from Dallas County Juvenile Department. Any probation officer and/or therapist from the county is able to make a referral to POETIC. If you or your agency is interested in making a referral, please email: referrals@iampoetic.org

Once submitted, you will receive a response within 48 hours. If youth is accepted, please email the following to referrals@iampoetic.org

Previous psychological evaluation(s) (PSAS)

Probation report

Educational records

Discharge Summary

 

Referral Questions

Referral Questions
First Name
Last Name
First
Last
Address 1
Address 2
City, State, Zip
Country
First Name
Last Name