"Every child deserves a CHAMPION- An adult who will never give up on them, who understands the power of connection and insists that they become the best that they can possibly be."
What's the Date of Referral?
Who is being referred?
Name, School, Grade, ID#
Reason for Referral? ie. Depressed, Bullying, Abnormal Behavior, etc.
What is the ideal time to see this student?
(What times would be best to come get this student? If this is an emergency please let me know.
Low (schedule when available) High (schedule as soon as possible) Emergency (Now)
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