OHS Request for Student Support Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Anyone can fill out this form, including an Oakland High School Student

If you suspect Child Abuse or Neglect YOU MUST notify CPS at 510-259-1800. If you are the student, and in a life threatening situation, please call 911.

We strive to reach the student and give you a status update within 5 days of receiving your referral. However, for more urgent matters, we hope to connect within 1-2 days.

Note: For disciplinary actions, please refer to universal office referral form or contact OHS Administrator.

Questions? Contact below:
Erik Fuller
EBAYC Program Director
SHOP 55 Wellness Center
Erik@ebayc.org

Email *

Which of the following applies to you? *

I am making a referral for myself

I am making a referral for student

Clear form

Never submit passwords through Google Forms.

This form was created inside of OUSD. Report Abuse

Forms