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KidsFirst Services Request Form

A variety of free and low cost programs are available to qualifying individuals through KidsFirst. 

Please complete the form below and click submit at the bottom of this page

PLEASE PROVIDE THE FOLLOWING CONTACT INFORMATION:

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If making a referral for someone other than yourself, please complete this section so that you may be contacted

REQUIRED, PLEASE COMPLETE:

FOR OFFICE USE ONLY:

ENGAGEMENT LOG:

Please complete below for any contact and/or contact attempt and document in Persimmony.
Please note that the service request form cannot be successfully submitted until all noted areas with a red asterisk (*) are completed.

Thank you for submitting your service request form. A KidsFirst team member will receive your request within one business day and will be in contact with you or the individual you referred within 3-5 business days. Please contact us at kidsfirst@kidsfirstnow.org or (916) 774-6802 if you have any questions. If you or your child is experiencing a mental health emergency please call 9-1-1 or the Placer County Adult Crisis & Intake 24-hour line at (916) 787-8860 or the Placer County Children’s 24-hour mental health crisis line at (916) 872-6549. Additional community resource information can also be found by calling 2-1-1 or visiting: https://211connectingpoint.org/placer-county/. Additionally, The Homeless Resource Helpline is 1-833-3PLACER

KidsFirst Counseling & Family Resource Centers

We are a non-profit, community-based organization operating counseling and family resource centers which empower, educate and strengthen families through prevention, early detection, intervention and treatment programs. All services are free, confidential & available in English & Spanish.

  • Call Us at (916) 774-6802
  • kidsfirst@kidsfirstnow.org

KidsFirst
Roseville

124 Main Street
Roseville, CA 95678
Tel: (916) 774-6802
Fax: (916) 774-2685

Office Hours:
Monday to Friday
9:00 a.m. to 5 p.m.

KidsFirst
Auburn

11960 Heritage Oaks Place, Suite 3
Auburn, CA 95603
Tel: (530) 887-3536
Fax: (530) 887-3856

Office Hours:
Monday to Friday
9:00 a.m. to 5 p.m.

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