This form is for agencies and organizations in Marin and Sonoma Counties who would like to appear in or edit the information available in the Find Your Way Resource Guide.

The Find Your Way resource guide is for middle and high school aged youth, and may can include some transitional-aged youth resources. We are looking to include only agencies or organizations that are youth friendly and accommodating.

Please contact Gabby Agar (gabby.agar@bluepathhealth.com) if you have any questions.

Question Title

* 1. What is your name?

Question Title

* 2. What is your email address?

Question Title

* 3. What is the name of your organization or agency?

Question Title

* 4. Contact Information:

Question Title

* 5. Description (1-3 sentences about your agency or organization and how you serve youth)

Question Title

* 6. Services offered that are available to youth (under 18):

Question Title

* 7. Do you provide services to TAY youth (18-26)? Please specify.

Question Title

* 8. Hours:

Question Title

* 9. Please select all of the topics/categories that your services for youth fall under (Note: some topics fall under multiple categories):

Question Title

* 10. Confidentiality:

Question Title

* 11. Cost

Question Title

* 12. Insurance:

Question Title

* 13. Additional questions or comments:

T