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Clear FormCONFIDENTIAL SCHOOLLINKED MENTAL HEALTH REFERRAL FORM Email completed referral form to: SLMHreferral LeeCarlsonCenter.org Today's Date: Date you contacted parent/guardian about the referral:
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How to fill out confidential school-linked mental health

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How to fill out confidential school-linked mental health

01
Contact the school administration or counseling department to inquire about the process of filling out the confidential school-linked mental health form.
02
Obtain a copy of the form, either through the school website or by requesting one from the school.
03
Read the instructions on the form carefully to understand the information that needs to be provided.
04
Fill in your personal details, such as name, address, and contact information, as requested on the form.
05
Provide any relevant medical or mental health history, including previous diagnoses, medications, and treatments.
06
Answer any additional questions on the form regarding your mental health concerns or reasons for seeking confidential school-linked mental health services.
07
Ensure that all the information provided is accurate and up-to-date.
08
Sign and date the form, indicating your consent to share the information with the appropriate school personnel.
09
Submit the completed form to the designated person or office mentioned on the form, if specified.
10
Follow up with the school to confirm that the form has been received and processed.

Who needs confidential school-linked mental health?

01
Confidential school-linked mental health services can be beneficial for various individuals, including:
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- Students who are experiencing mental health challenges or emotional difficulties
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- Students who have a diagnosed mental health condition and require additional support within the school setting
04
- Students who have experienced a traumatic event or significant stressors that impact their mental well-being
05
- Students who may be exhibiting signs of depression, anxiety, or other mental health concerns that affect their academic and social functioning
06
- Students who require counseling or therapeutic interventions to address behavioral issues or improve their overall mental health
07
- Students who need guidance and support in navigating personal or family-related difficulties
08
- Students who could benefit from early intervention and prevention strategies to promote overall mental wellness
09
It is important to note that the specific eligibility criteria may vary depending on the school's policies and available resources.
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Confidential school-linked mental health refers to mental health services provided to students within the school setting while maintaining the privacy and confidentiality of the student.
School counselors, psychologists, social workers, and other mental health professionals are required to file confidential school-linked mental health reports.
Confidential school-linked mental health reports can be filled out by documenting the mental health services provided to students, ensuring confidentiality and privacy are maintained.
The purpose of confidential school-linked mental health is to provide mental health services to students in a school setting while protecting their privacy and confidentiality.
Information such as the type of services provided, student's progress, any confidentiality breaches, and any necessary follow-up actions must be reported on confidential school-linked mental health.
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