top of page
Forms
NIRS DIRECT ADMISSION REFERRAL FORM
If you have not heard back about your online referral in 15 minutes, from submission please reach out to the program you are referring. See numbers below.
For Parent/Guardian Referral Process of a Youth 17 and under PLEASE CALL
319-229-2240
For Self ACCESS Program Adults 18+
PLEASE CALL
319-291-2455 ext6
bottom of page