Placer High School 2018/19 CoST (Collaboration of Services Team) Referral
CONFIDENTIAL REFERRAL FOR STUDENT SUPPORT
THIS REFERRAL IS NOT TO BE PART OF ANY STUDENT'S EDUCATIONAL RECORD.
LAST NAME of student you are referring (if you are a student seeking services for yourself, enter your Last Name here)
FIRST NAME of student you are referring (if you are a student seeking services for yourself, enter your First Name here)
Are you concerned about this student's immediate safety?
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