Youth Referral
Referral Form Instructions
For all prevention and intervention referrals for Ventura County and Santa Barbara youth up to age 25, please fill out our confidential form. If you suspect an individual, home, or business is experiencing human trafficking, call the National Human Trafficking Hotline at 1 (888) 373-7888 as well as your local law enforcement. In an emergency, call 9-1-1.
(1) Click the link button below based on your location and it will take you to a login screen.
(2) When you get to the login screen enter the following username and password:
Username: Refer
Password: Youth
(3) Fill out as many fields as possible.
If the information is unknown, please leave it blank.
Use the tab button to move from field to field.
If the field has a drop down menu, please choose the most appropriate selection.
In the event that you get an error message on a field indicating that you need to re-enter the information in that field, please readdress that field before moving on, otherwise no information after that field will save.