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SCHOOLED COMMUNITY COUNSELING SERVICES
INITIAL REFERRAL FORM
STUDENT INFORMATION
Students Name:
Referral Date:Date of Birth:Phone:State:ZIP Code:Current address:
City:
Legal Guardian:ParentGrandparentDCFSOther
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How to fill out school-based community counseling services

How to fill out school-based community counseling services
01
Start by collecting all necessary forms and documents such as consent forms, intake forms, and any other required paperwork.
02
Review the forms and familiarize yourself with the information that needs to be filled out.
03
Begin by filling out the basic demographic information of the student, such as their name, age, and contact details.
04
Provide information about the student's school, grade level, and any previous counseling services they may have received.
05
Fill out any necessary medical or mental health history information, including medications being taken or any diagnosed conditions.
06
Document the reason for seeking counseling services and any specific concerns or issues the student is facing.
07
Include information about any parental involvement or consent that may be required.
08
Fill out any additional sections or forms as specified by the school or counseling center.
09
Review the completed forms for accuracy and completeness before submitting them.
10
Submit the filled-out forms to the appropriate school-based community counseling services department or staff member.
Who needs school-based community counseling services?
01
School-based community counseling services are designed for students who require additional emotional, social, or behavioral support.
02
This can include students who are experiencing difficulties in their personal lives, such as family problems, grief or loss, relationship issues, or mental health concerns.
03
Students who are struggling academically or facing challenges in school, such as bullying, peer pressure, or stress, may also benefit from these services.
04
In addition, students who have experienced trauma, abuse, or other significant life events may require school-based community counseling services to help them cope and heal.
05
It is important to note that the specific criteria for eligibility may vary depending on the school or district's policies and available resources.
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What is school-based community counseling services?
School-based community counseling services are counseling services provided within a school setting to support students' mental health and well-being.
Who is required to file school-based community counseling services?
School counselors, mental health professionals, or agencies providing counseling services in schools are required to file school-based community counseling services.
How to fill out school-based community counseling services?
School-based community counseling services can be filled out by providing information on the number of counseling sessions provided, types of services offered, and outcomes achieved.
What is the purpose of school-based community counseling services?
The purpose of school-based community counseling services is to support students' mental health needs, promote academic success, and create a positive school environment.
What information must be reported on school-based community counseling services?
Information to be reported on school-based community counseling services includes the number of students served, types of counseling interventions used, and any referrals made to external providers.
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