Community Reset Referral Form

Thank you for referring someone to Rage Cage Joliet’s Community Reset Program. This monthly initiative provides selected individuals with a complimentary rage room experience as a positive, supervised outlet for navigating stress, grief, anxiety, frustration, life transitions, and other challenges.

Submitting a referral does not guarantee selection. Referrals will be reviewed privately, and selected individuals or a parent or guardian, if the participant is a minor, will be contacted by Rage Cage Joliet.

Please share only information that is relevant to the referral. Do not include confidential medical, counseling, or treatment records.