Straight Talk Referral

When Should You Refer a Youth to Straight Talk? 

Visit the FAQ's to get answers to some commonly asked questions.

 

Straight Talk Referral Form

Straight Talk Referral Process

Refer any youth age 8-17 who are at risk for, or exhibit high-risk behavior associated with all types of fire misuse (e.g., fire play, fire setting, arson, experimentation, fireworks, bottle bombs, etc.).

  1. Complete a referral form. Email it to: Kristy Brown kribro@med.umich.edu or Fax it to: 734-232-3833
    Referral Form (PDF)
  2. Complete a Waiver Disclosure form. (This is for referring schools, fire departments, police departments and social service agencies. Parent initiated referrals need not complete.) Fax it to: 734-232-3833
    Disclosure Form (PDF)
  3. Provide each custodial parent or legal guardian with:
    Straight Talk Family Information Forms (PDF).
  4. Parent/legal guardian must call or email to schedule their child/children into the Straight Talk program. To schedule call 734-232-3814 or email kribro@med.umich.edu