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USA Guides: Youth Transport Video logo Watch the stages of the USA Guides: Youth Transport Process

Troubled Youth/Teen Help Provider Directory
Troubled Youth/Teen Help Provider Directory

Youth/Troubled Teen Transport FORM

A well prepared and informed transport team is a safe team. To assure that our transport Guides are well informed and prepared for each transport it is important that we have extensive and thorough background information on the Teen we are to transport. This information is important as we will be spending, in a majority of cases, many hours together and will be engaged in conversations, and gives our Guides needed information on what topics of conversation to either avoid or engage in with the teen during a transport.

This information will also assist the guides in understanding and evaluating what may trigger inappropriate behavior in the teen. The information will also be used to effectively observe for medical or emotional problems.

Please fill out the form below


Form Navigation:

  • Mouse: Just click on any field and begin typing.
  • Keyboard: Use TAB to go through the form and use the SPACEBAR to select the radio buttons. (NOTE: only press ENTER when you are completely finished)
  • Click the SUBMIT button at the bottom when you are finished.

 

Please Provide Your Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Email: *
(Required)
Home Phone:
Ex: XXX-XXX-XXXX
Work Phone:
Fax Number:
Cellular Number:
Which number should we contact you with? Home
Work
Cell
On the Primary number you would like us to call back on, does it allow blocked calls? Yes
No
I / we have full legal custody and or rights to place this minor child in a school or program, and to contract for the services of USA Guides, Inc.
Yes No
Special notes or conditions concerning custody:
Directions to your residence from the nearest major airport:
Please provide the teen's Information:
Full Name:
Gender: Male
Female
Height: Feet: Inches:
Weight:
Hair Color:
Eye Color:
Age:
Date of Birth:
MM-DD-YYYY
Address of teen pick up:
Address of exactly where the teen will be at the start of the transport.
Any disablities or medical problems, describe in
detail and include any required medication information
School/Program
Facility Name:
Address:
Contact Person:
Phone:
Ex: XXX-XXX-XXXX
Email:
Educational Consultant
Consultant Name:
Email:
Phone:
Ex: XXX-XXX-XXXX
Address:
History Information
Do you know if your teen has been involved with drugs? If yes, do you know what type and frequency of use?
Do you know if your teen has been involved with Alcohol? If yes, do you know what type and frequency of use?
Do you feel that your teen is a flight risk? If yes, please explain:
Has your teen exhibited violence and or aggresive behavior? If yes, please explain in detail:
Other Problems/Issues:
Do any of the following apply to your teen?
If any can be answered "Yes" please provide a brief explanation:
Legal Problems:
School Problems:
Adopted:
Divorce Issues:
Fitting in Problems:
Emotional Problems:
Original Program (IF Transferring Schools)
Original Facility Name:
Address:
Contact Person:
Phone:
Ex: XXX-XXX-XXXX
Email:
Facility name of pickup:
Juvenile detention center or court name
Other Information/Notes

Please provide any other information about your teen, their circumstance, or any information that you feel is important for us to know about so that we can conduct an informed and safe transport:

Also, please answer the following questions: 

  • What date you would like this transport to take place?
  • Would you like to be contacted imediately after you submit?
wht  Parent Login
Case number:

Password:

wht  Testimonials
"I think you all did a wonderful job and I would recommend you to others. Thank you for your help in the stressful event. "
"We wanted to share our gratitude and appreciation for the magnificent and professional job USA Guides did today in escorting our son to the airport and to his program. We were so relieved and felt at ease knowing that our son was safe and in excellent hands. Once again, thank-you! Sincerely"

---Monique
"We were so pleasantly surprised by the calm and smooth transition that was made for our daughter between our home and her new school. Your Agents made Cindy feel safe and in the hands of caring friends rather than adversaries. Your staff provided for every situation and made us, as parents feel comforted as well."

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