Get the free CCSS Referral for Service referral form8-9-10 - Clark County - clarkcountynv

Clark County Social Service Hospital Referral Referring Agency: Worker Name: *Hospital Staff Only* Phone Number: FAX Number: Pinto 1600 Pinto Lane FAX:(702× 6761107 Date: ATTN: Lead Worker / Supervisor

How to fill out ccss referral for service

How to Fill Out CCSS Referral for Service:

1. Start by gathering all the necessary information. You will need the student's personal details, such as their name, date of birth, and student identification number.
2. Identify the reason for the referral. Determine the specific issue or concern that requires the student to receive additional services through CCSS.
3. Describe the student's current educational and behavioral characteristics. This includes their academic performance, social interactions, and any specific challenges or strengths they possess.
4. Provide relevant background information. Share any relevant medical or psychological history that may be impacting the student's educational needs.
5. Include any relevant assessments or evaluations. If the student has undergone any testing or assessments that support the need for CCSS services, attach these documents to the referral.
6. Discuss any prior interventions or strategies that have been implemented to address the student's needs. Describe the effectiveness of these interventions and why they are no longer sufficient.
7. Specify the desired outcomes or goals for the student. Detail what you hope to achieve through the provision of CCSS services.
8. Provide any additional information that may support the referral. This could include anecdotal evidence, teacher observations, or input from other professionals working with the student.
9. Sign and date the referral form, ensuring all required fields are completed accurately.
10. Submit the completed referral to the appropriate CCSS or special education department in your school or district for further review and consideration.

Who Needs CCSS Referral for Service:

1. Students who are struggling academically and require additional support to meet grade-level expectations may need a CCSS referral for service.
2. Students who have behavioral or emotional challenges that impact their ability to learn may require CCSS services.
3. Students with developmental delays or disabilities that require specialized instruction can benefit from CCSS referrals for service.
4. English language learners who require language support and accommodations may also need a CCSS referral.
5. Students who have recently experienced a significant life event, such as a trauma or loss, may need CCSS services to address their emotional and academic needs.
6. Students who have a documented medical condition or physical disability that impacts their ability to access the curriculum may require CCSS support.
7. Students who demonstrate consistent patterns of underachievement or lack of progress despite intervention may need a CCSS referral for a comprehensive evaluation and appropriate services.
8. It is important to remember that each school district may have its own specific guidelines and criteria for determining who needs a CCSS referral for service. It is recommended to consult with your school's CCSS or special education department for further guidance.

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What is ccss referral for service?

CCSS referral for service is a process where individuals or agencies can refer children or families for services through the California Child Support Services.

Who is required to file ccss referral for service?

Entities such as schools, healthcare providers, social service agencies, and individuals who come in contact with children and families are required to file CCSS referrals for service.

How to fill out ccss referral for service?

CCSS referral for service can be filled out online through the California Child Support Services website or by contacting their local child support agency.

What is the purpose of ccss referral for service?

The purpose of CCSS referral for service is to connect children and families with the support services they may need to thrive.

What information must be reported on ccss referral for service?

Information such as demographic details of the child or family, reason for referral, and any relevant medical or social history must be reported on CCSS referral for service.