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 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 firstname.lastname@example.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.