School Mental Health Counseling Referral Cover Sheet
This file provides a counseling referral cover sheet for the Los Angeles Unified School District. It outlines the necessary identifying information and how to properly complete the referral. It is essential for facilitating school mental health support services.
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How do I fill this out?
To fill out this form, begin by providing thorough identifying information about the student and their family. Ensure every section is completed to avoid any delays in processing the referral. Finally, submit the completed form to the specified School Mental Health Clinic via the provided email.
How to fill out the School Mental Health Counseling Referral Cover Sheet?
1
Complete the student identifying information section.
2
Fill in the family's preferred mental health clinic.
3
Provide detailed descriptions of the student's behaviors.
4
Check all applicable boxes regarding health coverage and services.
5
Submit the form via the designated email of the chosen clinic.
Who needs the School Mental Health Counseling Referral Cover Sheet?
1
Parents seeking mental health support for their children.
2
School counselors needing to refer students for additional help.
3
Social workers who need to document student services.
4
Healthcare providers coordinating with schools on student wellness.
5
Community organizations assisting families in need of mental health resources.
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Review the changes to ensure accuracy.
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What are the instructions for submitting this form?
To submit this form, email the completed document to the preferred School Mental Health Clinic listed on the cover sheet. For urgent referrals, you may also contact the clinic directly via the provided telephone numbers. It is advisable to follow up on submissions to ensure that the referral process is initiated.
What are the important dates for this form in 2024 and 2025?
For the years 2024 and 2025, stay aware of school start dates and key deadlines for mental health referrals. Often, referrals should be submitted early in the academic year to ensure timely services. It’s crucial to keep track of any specific deadlines communicated by the Los Angeles Unified School District.
What is the purpose of this form?
The purpose of this form is to provide a structured referral process for students needing mental health support. It assists in gathering critical information about the student and their circumstances, facilitating discussions between healthcare providers and schools. By completing this form, parents and guardians can ensure that their children receive the necessary help in a timely manner.
Tell me about this form and its components and fields line-by-line.
- 1. Name: Full name of the student.
- 2. DOB: Date of birth of the student.
- 3. School: School the student attends.
- 4. Referring Person: Name of the individual completing the referral.
- 5. Student ID#: Unique ID assigned to the student.
- 6. Health Coverage: Type of health insurance held by the family.
What happens if I fail to submit this form?
Failure to submit this form may result in delayed access to mental health services for the student. It is critical to provide all required information to avoid interruptions in service. Parents and guardians should ensure all sections are thoroughly completed before submission.
- Delay in Services: Incomplete forms may lead to a backlog in obtaining mental health support.
- Compromised Referral: Missing information could hinder the referral process, affecting timely assistance.
- Communication Issues: Failure to provide accurate contact details may delay follow-ups from clinics.
How do I know when to use this form?
- 1. Student Mental Health Concerns: When students display withdrawal or behavioral changes, this form can initiate support.
- 2. Family Support Requests: Parents seeking mental health evaluations for their children should use this form.
- 3. School Referrals: School counselors can utilize this document to refer students for additional mental health assessments.
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