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Social Work Assistance Request
Complete this form if you are in need of help from Lake Hamilton School District's social workers. They will be notified of your request and will contact you as soon as possible.
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* Indicates required question
Parent Name
*
Your answer
Contact Number
*
Your answer
Email Address
Your answer
Student Name (list all that apply)
*
Your answer
Student(s) are Enrolled In
*
Primary (K-1)
Elementary (2-3)
Intermediate (4-5)
Middle (6-7)
Junior High (8-9)
High School (10-12)
New Horizons
Required
Assistance Needed
*
Medicaid Enrollment/Re-enrollment
Counseling Referral
Referral for Social Services (financial assistance, food pantries, clothing, etc)
Other:
Required
Any other information that may help the social workers prepare to help you?
Your answer
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