Making A Referral
In order to be considered for a referral by the SWFMD, the individual must be 19 or under, at-risk for suicide, and face a financial barrier to receiving therapy on their own. A youth may be referred to our program by a Qualified Referral Source (QRS), which may include but is not limited to school counselors, members of the clergy, nurses or family practitioners, and probation officers.
All therapists in the Second Wind Fund of Metro Denver program are private therapists who are licensed by the State of Colorado, maintain malpractice insurance, have experience with teens at-risk for suicide, and have agreed to see Second Wind clients at a drastically reduced hourly rate.
Second Wind Fund of Metro Denver will pay for a student to visit a program therapist up to 20 times. Eight visits are automatically approved at the time of the initial referral. More visits require additional information after therapy has begun.
If you are concerned about a Denver Metro teen, please follow the steps below:
- Once it is determined that the youth may be eligible to receive therapy through Second Wind Fund of Metro Denver, the QRS contacts our office at 303-988-2645.
- After collecting basic information and a short narrative concerning the suicide risk and financial barrier, Second Wind Fund of Metro Denver issues a referral number for the student.
- Two forms should be completed, as described by Second Wind Fund of Metro Denver at the time of the referral, and parental consent should be obtained by the QRS if the youth is under 18.
- The youth and their family are encouraged to directly contact one of our 90 therapists to schedule an appointment within seven days of when the referral is initiated.
COUNTIES CURRENTLY COVERED BY SECOND WIND FUND OF METRO DENVER:
Adams County
Release of Information and Liability Waiver - Adams 12
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
Arapahoe County
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
Broomfield County
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
Denver County
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
Jefferson County
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
Park County
Release of Information and Liability Waiver
Release of Information and Liability Waiver (Spanish)
Referral Form
Referral Form (Spanish)
Therapist Roster
To request a referral in Douglas County or Boulder County, please visit the Second Wind Fund Affiliates website.
Resources for SWFMD Therapists
There are several forms frequently used by SWFMD therapists. They're included below:
Release of Information and Waiver of Liability Form
Release of Information and Waiver of Liability Form (Spanish)
Therapist Claim Form
