Get the free Crisis Counseling Referral Form - LAUSD - notebook lausd

Los Angeles Unified School District STUDENT HEALTH AND HUMAN SERVICES SCHOOL MENTAL HEALTH CRISIS COUNSELING & INTERVENTION SERVICES Crisis Counseling Referral Form

How to fill out crisis counseling referral form

How to fill out a crisis counseling referral form:

1. Fill out the personal information section: Provide your full name, address, phone number, and email address. This allows the counseling service to contact you if necessary.
2. Indicate the reason for referral: Specify the nature of the crisis you or the person you're referring is experiencing. This could include traumatic events, mental health concerns, or emotional distress.
3. Provide a brief description of the crisis: In a few sentences, summarize the main issues or symptoms related to the crisis. This helps the counselor understand the situation better.
4. Include any relevant background information: If applicable, provide details about previous counseling, mental health diagnoses, or medications. This information assists the counselor in tailoring their approach to the individual's needs.
5. Note any preferences or special requirements: If you have any specific preferences for a counselor, such as gender or language, or if you require any accommodations, make sure to mention them here.
6. Specify emergency contact information: In case of any immediate danger or crisis, provide the contact information of a trusted person who can be reached quickly.

Who needs a crisis counseling referral form?

1. Individuals experiencing a traumatic event: People who have been through a distressing or traumatic experience, such as an accident, natural disaster, or violent incident, may benefit from crisis counseling.
2. Individuals facing mental health challenges: Those dealing with mental health concerns such as depression, anxiety, PTSD, or suicidal thoughts can benefit from crisis counseling.
3. Individuals going through an emotional crisis: Crisis counseling can help individuals coping with grief, loss, relationship issues, or major life changes that are causing significant emotional distress.

Remember, crisis counseling referral forms help ensure that individuals in crisis receive the appropriate support they need.

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What is crisis counseling referral form?

The crisis counseling referral form is a document used to refer individuals experiencing a crisis to counseling services.

Who is required to file crisis counseling referral form?

Healthcare professionals, social workers, and other individuals who come into contact with individuals in crisis are required to file the crisis counseling referral form.

How to fill out crisis counseling referral form?

The crisis counseling referral form can be filled out by providing basic information about the individual in crisis, details about the crisis situation, and contact information for the counseling service being recommended.

What is the purpose of crisis counseling referral form?

The purpose of the crisis counseling referral form is to ensure that individuals in crisis receive the necessary counseling and support services to help them through their difficult situation.

What information must be reported on crisis counseling referral form?

The crisis counseling referral form must include the individual's name, contact information, a brief description of the crisis situation, and the recommended counseling service.