SAP Referral Form
The following is an anonymous referral form. You are not required to share your identity, but may if you choose.
If this is an EMERGENCY and you feel the student may be an immediate threat to themselves or others, please call 911.
Student's Name to be Referred:
Referred By: (optional)
Reason(s) for Referral
Please select all that apply.
Suspected Child Abuse/Neglect
Witness to (or Victim of) Traumatic Event
Poor/Inappropriate Peer Relationships
Gender Identity Issues
Please provide a brief description of the observable evidence of the reason(s) selected above.
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This form was created inside of Northern Lehigh School District.