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GHS Student Support Referral
Thanks for submitting a referral for a student.
I
f there is an urgent concern, please see someone in the Student Support Office or call the Main Office at 415-749-3600.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Phone Number
*
Your answer
Student Name
*
Your answer
Student's GATEWAY email address
*
Your answer
Does the student know you are referring them?
*
Yes
No
Maybe
I'm Self-Referring
Student's Gender Pronoun
*
He
She
They/them
Other:
Student's Race/Ethnicity
*
Your answer
Support services already in place
*
IEP
504 Plan
Therapist and/or Family therapist
Psychiatrist
Case Manager/Social Worker
I'm Not Sure
Other:
If Student has an IEP, have you checked in with the Case Manager?
Yes
No
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