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SCHOOLED BEHAVIORAL HEALTH REFERRAL FORM: SCHOOL STAFF Name of student: ___ Student #: ___Date: ___ Your name: ___Relationship to student: ___The schools school based behavioral health team may wish
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How to fill out school-based behavioral health referral
How to fill out school-based behavioral health referral
01
Obtain a school-based behavioral health referral form from the guidance counselor or school psychologist.
02
Fill out the student's personal information such as name, age, grade, and contact information.
03
Provide details on the reason for the referral and any specific behavioral concerns or issues.
04
Include relevant information about the student's academic performance, behavior in the classroom, and interactions with peers.
05
Obtain necessary signatures from parents or guardians before submitting the referral form to the designated school personnel.
Who needs school-based behavioral health referral?
01
Students who are experiencing emotional or behavioral challenges at school.
02
Students who may benefit from additional support or interventions to address their mental health needs.
03
Parents or guardians who are concerned about their child's behavior and well-being in a school setting.
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What is school-based behavioral health referral?
School-based behavioral health referral is a process through which students in need of behavioral health services are referred to appropriate resources within or outside of the school setting.
Who is required to file school-based behavioral health referral?
School staff members such as teachers, counselors, and administrators are typically required to file school-based behavioral health referrals.
How to fill out school-based behavioral health referral?
School-based behavioral health referrals can be filled out by providing information about the student's behavior, any related concerns, and the desired outcome or assistance needed.
What is the purpose of school-based behavioral health referral?
The purpose of school-based behavioral health referral is to ensure that students receive the necessary support and services to address their behavioral health needs and to promote their overall well-being.
What information must be reported on school-based behavioral health referral?
Information such as the student's name, grade, behavior concerns, past interventions, and any other relevant details must be reported on a school-based behavioral health referral.
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