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The following questions have been adapted from the screening tool developed by Wellspring Living & Georgia Cares. This form IS NOT INTENDED AS AN INTERVIEW FORM with questions to be asked of the youth directly. It is New Hope’s opinion that such interviews should be handled by (or in the presence of) licensed mental health professionals.
Instead, this form should be completed by (or with the assistance of) persons who are familiar with the child and their circumstances. Such persons might include foster parents, case workers, counselors, CASA, and etc. Feel free to use this form and the narrative field both if you feel responses require some explanation.
Thank you for completing this referral form! New Hope is anxious to partner with Arkansas DHS /DCFS in the restoration of youth who have a known or likely history of human trafficking and who meet the “Referral Criteria.”
New Hope seeks to provide:
In the event that DHS should be contacted concerning care for any trafficking survivors not within the AR DHS system, New Hope will accept referrals from any location in Arkansas to assist in finding restorative placements for these survivors. Our contact information may be shared with any agency or individual.
New Hope will accept NEW REFERRALS for youth meeting these criteria:
New Hope staff will meet with the foster family and with the youth themselves prior to assignment of a volunteer mentor. Mentors are assigned as our volunteer availability permits. A mentor will be assigned who is of the same sex as the student.
As volunteer availability allows, we will attempt to assign a mentor of the same race as the student to provide a positive role model to whom the student can readily relate. If a mentor of the same race is unavailable, a mentor of a different race will of course still be assigned. New Hope provides services without discrimination except as pertaining to the referral criteria.
For questions, please contact us by phone at 501-777-5955 or via email at [email protected].
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