SERVES Referral

1 Start 2 Complete

SERVES provides peer-to-peer support and community referrals to employees and their families in times of need and delivers resilience-promoting interventions to staff members and their families.

If you would like to make a referral for a member of the SERVES team to contact you or a team member, please complete the following information. This information will be sent directly and confidentially to a SERVES team member.

Your name *

Your phone number *

Best time to contact *

Your NDCS facility *

Who are you referring? *

Self

Team member

Concerns

Please list the concerns you would like to share with SERVES. This will assist the SERVES team in delivering the appropriate resources to you.

Name of team member you are referring

NDCS facility

Phone number of team member (if known)

Referral information

If you are referring another team member, please list the relevant concerns. This will assist the SERVES team in delivering the appropriate resources to the team member. A SERVES team member may also contact you to follow up on this referral.

Safe Prisons.

Transformed Lives.

Safe Communities.

Our Mission:

Keep people safe.

SERVES Referral

SERVES Referral

Nebraska Department of Correctional Services

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