Confidential Referral Form
If you are experiencing a life-threatening emergency, call 911 immediately.  Other community resources include Mobile Assistance Community Responders of Oakland  the City of Oakland  (510) 44 MACRO | (510) 446-2276.  

The confidential referral form supports individuals and families before and during a crisis. Complete the form to be connected with the appropriate staff. 

Request are reviewed on a rolling basis. You should expect to hear from us within 48hours.  If you have questions for us feel free to call our office M-F 9-5pm 510-931-7569 and after hours you can leave a message at 1-888-RJCARES (1-888-752-2737)

Complete the form to the best of your ability.  The more details you add the better to allow us to assist you.

Thank you-RJOY
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Name *
Email *
Phone Number(s)
Once you fill this form out, we will be emailing you.  After this initial email, would you prefer a text, phone call or email communication?
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Is it okay to leave a message? 
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Who is making the referral? 
If you are contacting us on behalf of someone else can you provide their name and contact info below if possible or any other contact info?
Please tell US ABOUT THE CURRENT SITUATION that brings you to make a request for support from Restorative Justice for Oakland Youth (RJOY)?  What support do you need?
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