Request Consultation

Please fill out this form to the best of your ability so we can understand how to meet your needs.

If you would like help filling out this form please contact our Referral Specialist at 414-865-6608

Request Consultation

If yes, please provide the site’s Provider Number and Location Number. How to find these numbers.
Please choose from the following:

Child/Family: Consultant collaborates with families and caregivers and staff to understand and respond effectively to a child’s mental health needs. Assists caregivers to understand and effectively respond to the mental health needs of a family. Consults to families, other caregivers and staff about a particular child or family.

Classroom/Teacher: Consultant explores how the classroom supports all children’s social emotional development. Collaborates with parents and caregivers to assess relationships, routines, and practices that impact the classroom or home climate.

Programmatic: Consultant assesses a program’s systems, policies, procedures, professional development, philosophy and mission as they relate to supporting mental health of young children and their families.

Community: Assists organizations, systems, and communities to improve social, emotional, and behavioral outcomes through partnership, collaboration, and coordination. Activities include: providing outreach and engagement related to IMH, IECMHC, and other related topics; linking families, groups, and organizations; supporting cultural awareness, responsiveness, and celebration; facilitating training and education for families and the broader community; tracking community needs to inform larger system improvements; and, connecting families to events and opportunities for recreation and community participation.

Consultation Information

(Infant and Early Childhood Mental Health Consultation (IECMHC))
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