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Thank you for your referral! This section is for Caseworkers/ planners, Social Workers, Attorneys, Court Clerks, PO's, Counselors ADA's, Therapists etc.

Download and complete the fillable PDF referral. Once complete please sign and upload.

Note: All FM clients are mandated for parenting as a program requirement.

Fatherhood Matters Referral Form (Fillable Form).pdf

First & Last Name *

Email *

Referring Party/ Agency * ACS (Child Services) Preventive/ Foster Care IDV Court / DA Attorney / Legal Services Criminal Court Probation / Parole Re-entry Program Substance Program Other

Borough/County* Staten Island / Richmond The Bronx / Bronx Manhattan / New York Queens / Queens Brooklyn / Kings

Message *

Court Documents Maximum upload file size: 12 MB

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