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Welcome to the UES Referral & Intake Portal.
Please select the form that best fits your needs.
All information is confidential and protected.
Client Referral Form (General)
Client Referral Form (General)
For individuals, families, or community partners.
School/Agency Referral Form
School/Agency Referral Form
For teachers, counselors, principals, caseworkers, truancy officers.
Legal Advocacy Referal Form
Legal Advocacy Referal Form
For court related, truancy, DHS/CPS,probation, attorneys, public defenders.
Confidentiality Agreement
Confidentiality Agreement
Everyone must acknolwedge confidentiality before services begin.
What Happens After You Submit
• UES will review your information within 24–48 hours.
• A staff member will contact you directly by email or phone.
• If accepted, you will receive a secure Welcome Packet with next steps.
• All onboarding documents are distributed directly to accepted clients only.
• For urgent situations, email us directly.
• All information submitted is confidential.
For questions email: contact.urbalessence@gmail.com
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