REFERRAL FORM
This form is to be used to help identify students that may be in need of additional support. Responses will be read from 7:30 AM to 4:30 PM, Monday - Friday. Please be mindful that follow-up is not immediate and, in some instances, may take a day, especially if a referral is made on the weekend. If it is NOT AN EMERGENCY and it is after hours, please fill out this form and then come and find an administrator as soon as possible.
THOUGHTS
OF HURTING YOURSELFIf you are thinking of hurting yourself, please call the National Suicide HOTLINE 1-800-273-8255 or if it is a life threatening emergency, please call 911 and tell them your location.
THREATENING OTHERS
If someone is threatening to hurt others or has made a threat against the school during school hours, please find an administrator and let them know. If it is after-hours please call 911.
Please be considerate of student confidentiality with regard to sensitive issues and be mindful of the information shared on this form. If you have questions please contact Ms. Gomez, Principal (Main Office), Ms. Medina, Coordinator (Room 122), Ms. Montoya, Coordinator (Room 101), or Ms. Espinoza, PSW (Room 136) or call the Main Office 323-441-4601. Thank you.
