Refer a young person

The Service aux jeunes (SAJ) project is aimed at young Laval residents between the ages of 12 and 24 who are at risk of involvement or are already involved in a criminal network. According to your observations and the needs expressed by the young person (and his/her family, if applicable), the team of professionals involved will provide support and, if necessary, individualized referrals to the appropriate assistance resources in Laval.



    * = Required

    YesNoI don't know

    Attracted to—and at risk of involvement in—a criminal networkInvolvedin a criminal network;

    Yes;No, but he/she would like to meet with the Clinical supervisor in order to find out more about the project.


    1. INFORMATION ABOUT THE YOUNG PERSON CONCERNED IN THE REQUEST

    FrenchEnglishOther


    2. REFERRAL INFORMATION


    3. To your knowledge, does the referred young person (and/or his/her family) receive services from one or more Laval organizations? If so, which ones?

    4. RISK FACTORS

    Referral of a young person to the project should be based on the presence of numerous risk factors in several areas of his/her life (individual, peer-related, school, etc.). According to your observations and clinical judgment, check/highlight the factors observed in the young person referred:

    Positive attitude towards violent behaviourLow level of self-control (impulsiveness and/or aggressiveness)Difficulty(s) with integration and/or cultural identityInvolvement in criminal activities (e.g. robbery, assault, drug trafficking, pimping, group crimes, fighting)Delinquency and/or previous behavioral disorder(s)Alcohol and/or drug useSocial exclusionPrevious YCJA custody order and/or jail sentence(s)

    Low level or absence of parental supervision/ controlCriminalized and/or gang-affiliated family members (parents, siblings)Low socio-economic status of the family

    Frequent involvement with delinquent or gang-affiliated peers and/or rejection of positive social (pro-social) peersMember of a gang culture (e.g., allegiance to a criminal gang with a group name, has been assigned a nickname, wears distinctive colours, tattoos, displays luxury items)

    Low level of attachment to school and/or career aspirationsLow academic achievementPoor school attendance

    Lives and/or frequently visits targeted sectors (Chomedey, Pont-Viau / Laval-des-Rapides, Saint-François and Vimont)

    5. DETAIL, IF NEEDED, THE REFERENCE MOTIVES.

    6. What is the main reason for the referral?

    7. Did the referred young person identify and/or express particular needs? If so, which ones?

    8. To your knowledge, what strengths and/or protective factors should be emphasized? (e.g., extracurricular activities, family support, good self-esteem)?

    ***If you have technical issues with the form, download the PDF version and please send the form to Chloé Robitaille at projetsaj.laval@gmail.com. If you have any questions, you may contact the Clinical supervisor at 450-543-0413.

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