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Request A Forensic Interview
Referrals for forensic interviews are only accepted from Law Enforcement and Child Protective Services. If you are with one of these agencies, please fill out the form below to the best of your ability and we will contact you shortly with available dates and times. Any questions, please contact Andrea Mills at firstname.lastname@example.org, or (989) 317-8790. Thank you, we look forward to working with you!
If you do not hear back from us within 24 Hours, please contact us directly via phone or email.
Referral Agency (ie. Law Enforcement, CPS, etc.)
Other involved Agencies (i.e. Law Enforcement, Child Protective Services, Mental Health, etc.)
Available Dates for Forensic Interview (This should include what works best for all team members involved)
Child's Name, Date of Birth, Address, Gender, Any Special Needs
Non-Ofending Caregiver's Name, Phone Number, Address, Relationship to Child
Alleged Offender's Name, Date of Birth, Address, Relationship to Child
Summary of Allegations
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