Welcome to BRIDGES!
BRIDGES Transitional Living Program
BRIDGES is a three phase program for adolescents aged 16 – 22 who have no
safe living environment with family or relatives available to them.
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Phase I (YRCII) is a residential center that teaches youth the basic skills to
succeed in life in a dorm-like setting.
Phase II (TLP) is the transitional living phase of the program, where youth
live in an apartment with an on-grounds monitor, and put into practice
the skills that they have learned.
Phase III (CIP, available to youth in custody) allows youth to live out in the
community and use TLP/BRIDGES staff as a resource and a support.
Up to 2 years of continued support
Additional services include:
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Nurse On-Call
Case Management
Educational and Employment Assistance
Mental Health Assessment
Drug and Alcohol Assessment
Crisis Counseling
Referral Services
Transportation
Financial Support for Continuing Education
Financial Planning, Literacy and Budgeting
INTERNSHIP Opportunities
Get started on the path to independence!
BRIDGES Transitional Living Program Youth Application 1
Items to Complete Prior to Admission to the Transitional Living Program
We are glad that you are interested in the Wichita Children's Home BRIDGES Transitional
Living Program (TLP). There are several steps for you to complete in order to be considered for
admission to BRIDGES/TLP. The following is a list of items necessary for you to be considered
as a candidate for the program:
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Application Packet – Fill this out as soon as possible.
Goals – On the attached form, write out three (3) short term goals for the next six (6)
months and three (3) long term goals for the next six months to two years.
Autobiography – On the attached form, write a short history of your life so far. It should
be one to three pages and should include how you got to where you are now.
After your application is received and reviewed, you will be contacted by Street Outreach.
Street Outreach will work with you, and if they feel that BRIDGES would be a good fit, you will
be considered for a spot in one of the programs Orientation Beds.
Once in an Orientation Bed, you will be assigned a BRIDGES Case Manager who will help you
in completing the following steps:
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Mental Health Assessment – You will need to schedule a short mental health assessment
to determine if you have any mental health needs or issues of which we should be
aware.
Substance Abuse Assessment – You will need to schedule a short substance abuse
assessment to determine if you have any alcohol or drug use issues of which we should
be aware.
Health Checkup – You will need to contact you own doctor. If you do not have a
medical doctor, your BRIDGES Case Manager can help you schedule this checkup.
You will need to provide a copy of the following documents for our records: Original
Birth Certificate, Social Security Card, Driver’s License or Kansas Identification Card,
High School Diploma or GED, and Medical Card or Insurance Card.
After all this information is gathered, and you have completed all of your assessments, you will
officially be considered a resident in the program.
If you have any questions or concerns, please contact the following:
Jessica DeCavelle
BRIDGES TLP Coordinator
810 North Holyoke
Wichita, Kansas 67208
316-268-9368 (office)
316-268-9391 (fax)
j_decavelle@wch.org
Teresa Buchanan
BRIDGES YRC II Manager
810 N. Holyoke
Wichita, KS 67208
316.681.6711 (office)
316-684-7249 (fax)
t_buchanan@wch.org
BRIDGES Transitional Living Program Youth Application 2
BRIDGES Transitional Living Program
Youth Application
Today’s Date:
Name:
Date of Birth:
Gender:
Age:
Race:
Ethnicity:
Social Security Number:
Referred by:
Medical Card Number/Name of Insurance:
With whom are you currently living?
Current Address:
Current Phone:
Do you have any children or are you expecting a child? Please list the ages or expected due date
of your child/ren:
Reason for applying for the BRIDGES Program:
Have you ever been, or are you currently in custody? If so, please list case manager’s name, and
any information related to custody:
Mother’s Name:
Mother’s Phone:
Mother’s Address:
Father’s Name:
Father’s Phone:
Father’s Address:
BRIDGES Transitional Living Program Youth Application 3
School History
Current School:
Grade:
Type of Diploma:
Graduation Date:
Honors and Awards:
What do you like best about school?
What do you like least about school?
If you are not attending school, tell us what is the highest grade completed and what is your plan for
completing your education?
What are your goals for your education?
Work History
Are you employed?
Current employer:
Employer’s Phone Number:
Length of employment:
Previous employer:
Length:
Previous employer:
Length:
What type of work do you want to do for a living?
BRIDGES Transitional Living Program Youth Application 4
Medical/Mental Health
Do you have a medical or mental health diagnosis?
Have you received treatment?
Are you receiving treatment currently?
Have you ever been in Therapy or Counseling? If yes, with who and how long?
Have you ever tried to harm yourself or someone else? Please give details:
Do you take any medications? What are the medications for? Do you take medications as prescribed?
Have you ever been hospitalized? If yes what were you hospitalized for and how long?
Family Doctor:
Phone:
Does your family have a history of medical problems? If yes, please explain:
BRIDGES Transitional Living Program Youth Application 5
Drug/Alcohol Abuse
What is the extent of the youth’s drug and alcohol history?
What treatment have you received?
Did you successfully complete treatment?
How long have you been drug/alcohol free?
What did you learn from the treatment program?
Describe any past or current alcohol or drug problems?
Are you willing to start or continue treatment if accepted into the program?
If not, Why?
Criminal Record
What did you do that resulted in this record?
What is the current status of your record – on parole, probation, etc?
Do you have any outstanding tickets or court cases pending?
BRIDGES Transitional Living Program Youth Application 6
Goals
Please write down three goals you would like to accomplish in the next six months.
Goal 1:
Goal 2:
Goal 3:
Please write down three goals you can accomplish in the next two years.
Goal 1:
Goal 2:
Goal 3:
BRIDGES Transitional Living Program Youth Application 7
Autobiography
Please write a brief history of your life and how you got to where you are today. Use extra sheets if
necessary.
BRIDGES Transitional Living Program Youth Application 8
BRIDGES Transitional Living Program Youth Application 9
BRIDGES Transitional Living Program Youth Application 10