IMPORTANT NOTICE
REFERRAL AUTHORIZATION

LETI referrals involving pending charges, consideration of charges, or an alternative to prosecution must be initiated or authorized by the appropriate law enforcement agency or District Attorney’s Office.

Referrals submitted by individuals or entities outside of law enforcement or the District Attorney’s Office must receive prior approval from the appropriate prosecuting authority before submission.

Unauthorized referrals will not be eligible for consideration and will result in disqualification from the LETI program under Track 2 and Track 3.

LETI REFERRAL FORM

REFERRAL - BIO INFORMATION

NEEDS IDENTIFIED - Complete for Guardian Referrals only:


Referral Acknowledgement

The information provided in this referral form will be shared with the appropriate participating LETI partners, including relevant local treatment providers and community service organizations. By completing the referral form, I authorize LETI to share my information with those participating LETI partners, treatment providers and community service organizations; this authorization extends to any and all attachments in my case file.

Submitting this form does not guarantee acceptance into a particular program, treatment placement, diversion from criminal charges or any specific outcome.


If this is an emergency or someone is in immediate danger, please call 911.
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