Viking TNT Referral
This program targets children who are in foster care and those who are not with social-emotional or behavior issues who could benefit from receiving mental health services.
Your name (Referring person) *
Student's name *
School *
Is the student in foster care? *
Does the student have an IEP? *
Is the student currently receiving mental health services? *
If yes, what services are they receiving? Click all that apply.
Have you completed a SAEBRS assessment? *
Describe your concerns (academics, behavior, attendance). *
Has the student been brought to SIT? *
What have you tried (interventions) to address these concerns? *
Have you spoken with your principal and are they in agreement that this student is a good candidate for the pilot? *
Describe the parent/caregiver's knowledge of your concerns? Who did you speak to? *
Have you mentioned to the parent that you are referring the student to the pilot and are they interested? *
When is a good time during the day that is the best to pull the student out of class? *
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