Merced High Counselor Referral Form
If you would like to refer a student to their academic counselor or to the Crisis Counselor please complete the following form.
Referral to:
Date:
Your answer
Name of student:
Your answer
Student ID #
Your answer
Student's grade level
Please check off all of the following that apply:
Required
Additional comments:
Your answer
Your name
Your answer
Is it okay to tell the student that you made the referral?
Submit
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