Provider Referral Form

The We Play Center is a FREE indoor play space for children ages birth-3 with an adult caregiver. The We PLAY Center is designed to offer a safe place to play while engaging in activities that promote brain development. In addition TrainingGrounds offers onsite Parent Learning Opportunities, Autism Support Program, Bonding and Brain Building that are available to the community. Please complete the referral form below and a staff member will personally reach out however, you do not have to wait to be invited - play sessions are ongoing and year round!

Name of Person Making the Referral

First Name

Last Name

Your Email

Your Phone

(###)

###

####

Referral Agency

Caregiver's Name

First Name

Last Name

Caregiver's Email

Caregiver's Phone

(###)

###

####

Child's Name

First Name

Last Name

Child's Date of Birth

YYYY

Please Select The Program You Are Referring To:

Any other Additional Information You Can Provide

Does the family you are referring need services in Spanish?

Yes

Greeting Service Providers,

TrainingGrounds will be closed for staff to spend time with their families for the holidays from 12/23/2024 to 1/3/2025, and for staff development from 1/6/2025 to 1/10/2025. During this time, we are still accepting referrals, and families will be contacted once we reopen on 1/13/2025.

If you are working with families in need of immediate assistance, the Louisiana Parentline provides a safe space for parents to express their frustrations, ask parenting questions, and receive support. Specialists are available to offer emotional support, de-escalation, crisis intervention, information and referrals, and coping strategies. Follow-up calls can also be arranged to help parents expand their circle of support.

The Louisiana Parentline is available 24/7 and can be reached by dialing 833-LA-CHILD or texting 225-424-1533.

Provider Referral Form

My TrainingGrounds, Inc.