fbpx

Records Request

To provide consent to Youth Home to correspond with you via email, please complete the form below:

CONSENT TO E-MAIL COMMUNICATIONS

To request access to your Youth Home records, please complete the form below:

REQUEST FOR ACCESS FORM

To provide authorization for Youth Home to disclose your protected health information to another entity, please complete the form below:

AUTHORIZATION TO DISCLOSE HEALTH INFORMATION

To provide authorization for another entity to disclose your protected health information to Youth Home, please complete the form below:

AUTHORIZATION FOR DISCLOSURE TO YOUTH HOME

DONATE TO YOUTH HOME

Donate to support healing and hope. Learn more about the impact of your gift and ways to give!

donate

Become A Volunteer

Join the amazing folks on Team Youth Home for updates about volunteering on our campus or at our events throughout the year.

get started

Receive our Newsletter

Sign up for our News and Events eNewsletter to stay in-the-know with what's happening at Youth Home.

Sign Up

Donate to Youth Home

While Medicaid covers a portion of the daily expenses for our residential patients, there is still an annual deficit.

Your gift allows Youth Home to help those who need help the most and ensures that our programs are exceptional. Join our effort to change lives and save families.

Youth Home, Inc. is a 501(c) (3) non-profit organization. Eligible contributions are tax deductible.

Donate Today

Contact Youth Home

Address:
20400 Colonel Glenn Road
Little Rock, Arkansas 72210 
MAP

PHONE: 501-821-5500

EMAIL: info@youthhome.org

Hours:
Monday-Friday: 8:30 am to 5:00 pm
Saturday-Sunday: Closed