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SCHOOLBASED HEALTH CENTER REFERRAL FORM The UNMMG SBHC must operate under specific confidentiality laws pertaining to the delivery of certain health care services. Although SBHC personnel strongly
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How to fill out schoolbased health center referral

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How to fill out schoolbased health center referral

01
Obtain a referral form from the schoolbased health center or your school's health office.
02
Fill out all required information on the referral form, including your name, contact information, reason for referral, and any relevant medical history.
03
Make sure to sign and date the referral form before submitting it to the schoolbased health center.

Who needs schoolbased health center referral?

01
Students who require medical attention or treatment that is beyond the scope of the school nurse's capabilities
02
Students who need to see a healthcare provider for a specific health concern or ongoing healthcare needs
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A school-based health center referral is a formal process that connects students to healthcare services available at or through the school-based health center, ensuring they receive necessary medical attention and support.
Typically, school staff, including nurses and counselors, are required to file school-based health center referrals when they identify a student in need of medical or mental health services.
To fill out a school-based health center referral, one must provide the student's personal information, details about the specific health concern, the recommended services, and any other relevant medical history or consent forms.
The purpose of a school-based health center referral is to facilitate access to health services for students, promote health and well-being, and ensure that students receive ongoing care and follow-up.
The information that must be reported includes the student's name, date of birth, health issues identified, recommended services, and contact information for both the parent/guardian and the health center.
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