Social-Emotional Support Referral Form

STUDENTS: If you or a friend of yours is in need of social or emotional support, and it is not a life threatening emergency, please fill out the referral form. *If you or someone you know is in an immediate suicidal crisis, call 911 immediately. If you have thoughts of suicide or just need to talk with someone, you can call the Suicide Prevention Hotline at 800-273-8255 (Available 24 hours a day, 7 days per week).

PARENTS AND STAFF: If you are concerned about your child or student’s social emotional well-being, please fill out the referral form. *If your child is in an immediate suicidal crisis, call 911 or take your child to the nearest emergency room.

STAFF FOR STAFFIf you are concerned about your own well-being or the well-being of an adult peer or coworker, and it is not a life threatening emergency, fill out the referral form.