SAP REFERRAL MS
SAP Referrals are only checked during the school day. If you are making this referral during after-school hours and your concerns are urgent in nature, please contact the Lehigh County Mental Health Crisis Hotline at (610) 782-3127 to receive immediate assistance. If there is a life-threatening emergency, call “911” or visit your nearest emergency room.

All information should be specific, descriptive, observable, and factual.
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What is the student's first name? *
What is the student's last name? *
Check reasons for concern *
Required
Please elaborate on the reason(s) for the referral and any other information that would be helpful to the team.
Prior to this SAP referral, please check any actions taken to help this student *
Required
I would like to speak to a SAP team member regarding this student. *
Name and Contact information
This will enable the team to contact you if they need additional information.
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